Provider Demographics
NPI:1164553525
Name:MUNOZ, NELIDA (MT)
Entity Type:Individual
Prefix:
First Name:NELIDA
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 979
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00986-0979
Mailing Address - Country:US
Mailing Address - Phone:787-505-6670
Mailing Address - Fax:
Practice Address - Street 1:OFIC. 312 CAROLINA SHOPPING COURT
Practice Address - Street 2:CARR. 3
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-757-1040
Practice Address - Fax:787-757-1040
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3868246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist