Provider Demographics
NPI:1285832741
Name:MUNOZ, JORGE FERNANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:FERNANDO
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 CALLE ROSARIO
Mailing Address - Street 2:COND. EL ROSARIO 306
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00912
Mailing Address - Country:US
Mailing Address - Phone:214-794-6509
Mailing Address - Fax:
Practice Address - Street 1:256 CALLE ROSARIO
Practice Address - Street 2:COND. EL ROSARIO 306
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912-3113
Practice Address - Country:US
Practice Address - Phone:214-794-6509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17645208000000X, 2084N0402X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology