Provider Demographics
NPI:1164505152
Name:MUNIZ BERNABE, GERMAN (OD)
Entity Type:Individual
Prefix:
First Name:GERMAN
Middle Name:
Last Name:MUNIZ BERNABE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3-31 CALLE CORDOBA
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-3126
Mailing Address - Country:US
Mailing Address - Phone:787-884-5708
Mailing Address - Fax:787-884-4439
Practice Address - Street 1:LOCAL F10
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968
Practice Address - Country:US
Practice Address - Phone:787-273-0490
Practice Address - Fax:787-273-0666
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR205152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist