Provider Demographics
NPI:1275807125
Name:MUNOZ, MILADY (PTA)
Entity Type:Individual
Prefix:
First Name:MILADY
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21331 SW 99TH CT
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3101
Mailing Address - Country:US
Mailing Address - Phone:786-344-3483
Mailing Address - Fax:305-254-9027
Practice Address - Street 1:21331 SW 99TH CT
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-3101
Practice Address - Country:US
Practice Address - Phone:786-344-3483
Practice Address - Fax:305-254-9027
Is Sole Proprietor?:No
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 23110174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist