Provider Demographics
NPI:1235447582
Name:MUNIZ-MEDINA, REBECCA (DC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:MUNIZ-MEDINA
Suffix:
Gender:F
Credentials:DC
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 546
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-0546
Mailing Address - Country:US
Mailing Address - Phone:787-830-8855
Mailing Address - Fax:787-872-5006
Practice Address - Street 1:4030 AVE MILITAR
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-4154
Practice Address - Country:US
Practice Address - Phone:787-830-8855
Practice Address - Fax:787-872-5006
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR482111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor