Provider Demographics
NPI:1346321866
Name:MUNOZ, GLORIA M (PHT)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:M
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:PHT
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 1451
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-1451
Mailing Address - Country:US
Mailing Address - Phone:787-453-9804
Mailing Address - Fax:
Practice Address - Street 1:21 ST. T-3 NO.6 URB LAS LOMAS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-783-4368
Practice Address - Fax:787-781-1539
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2708183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician