Provider Demographics
NPI:1558686287
Name:MUNRO, ANASTACIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANASTACIA
Middle Name:
Last Name:MUNRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9260 W SUNSET RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-4903
Mailing Address - Country:US
Mailing Address - Phone:702-255-3547
Mailing Address - Fax:702-921-2419
Practice Address - Street 1:9260 W SUNSET RD STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-4903
Practice Address - Country:US
Practice Address - Phone:702-255-3547
Practice Address - Fax:702-921-2419
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NV15403207L00000X
FLME118950207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012051500Medicaid
FL012051500Medicaid
FLHU926ZMedicare PIN