Provider Demographics
NPI:1497420509
Name:MUNOZ, MALENA (MSN, APRN, FNP)
Entity Type:Individual
Prefix:
First Name:MALENA
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:MSN, APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12520 SW 222ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-4493
Mailing Address - Country:US
Mailing Address - Phone:305-300-5912
Mailing Address - Fax:
Practice Address - Street 1:12520 SW 222ND TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-4493
Practice Address - Country:US
Practice Address - Phone:305-300-5912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014717363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily