Provider Demographics
NPI:1376918631
Name:MUNOZ, ANAHI PENELOPE (APRN)
Entity Type:Individual
Prefix:
First Name:ANAHI
Middle Name:PENELOPE
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:DR
Other - First Name:ANAHI
Other - Middle Name:P
Other - Last Name:MUNOZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP-FNP-PMHNP-APRN
Mailing Address - Street 1:1835 NW 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-4022
Mailing Address - Country:US
Mailing Address - Phone:954-871-4229
Mailing Address - Fax:
Practice Address - Street 1:4300 N UNIVERSITY DR
Practice Address - Street 2:STE C103
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6243
Practice Address - Country:US
Practice Address - Phone:954-478-5763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-11
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9257765363LP0808X
FLAPRN9257765363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL13839767OtherCAQH
FLGH709AMedicaid