Provider Demographics
NPI:1447237862
Name:MUNIZ CRIM, ALISA J (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISA
Middle Name:J
Last Name:MUNIZ CRIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALISA
Other - Middle Name:
Other - Last Name:CRIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3100 SW 62ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3009
Mailing Address - Country:US
Mailing Address - Phone:305-661-6110
Mailing Address - Fax:
Practice Address - Street 1:3100 SW 62ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3009
Practice Address - Country:US
Practice Address - Phone:305-666-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1029692080P0206X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No133N00000XDietary & Nutritional Service ProvidersNutritionist