Provider Demographics
NPI:1639155252
Name:MUNOZ-MARIN, ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:MUNOZ-MARIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 CALLE AMERICO SALAS
Mailing Address - Street 2:
Mailing Address - City:SANTURCE
Mailing Address - State:PR
Mailing Address - Zip Code:00909-2138
Mailing Address - Country:US
Mailing Address - Phone:787-722-7403
Mailing Address - Fax:787-726-4196
Practice Address - Street 1:1446 CALLE AMERICO SALAS
Practice Address - Street 2:
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909-2138
Practice Address - Country:US
Practice Address - Phone:787-722-7403
Practice Address - Fax:787-726-4196
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5829174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR65657OtherCRUZ AZUL - CONSULTORIO
PRN596OtherFIRST MEDICAL
PRSE3393OtherPALIC
PR97384MUOtherTRIPLE S
PR455829OtherU.I.A.
PR220262OtherPREFERRED HEALTH PLAN
PR600063OtherMEDICARE Y MUCHO MAS
PR66961OtherCRUZ AZUL-LABORATORIO
PR8000429OtherHUMANA HEALTH PLAN
PR2883OtherPREFERRED MEDICARE CHOICE
PR8000429OtherHUMANA HEALTH PLAN
PRN596OtherFIRST MEDICAL