Provider Demographics
NPI:1689091514
Name:MUNIZ, KEILA SIOMARA (MD)
Entity Type:Individual
Prefix:
First Name:KEILA
Middle Name:SIOMARA
Last Name:MUNIZ
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 1:104 UNION AVE STE 804
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1844
Mailing Address - Country:US
Mailing Address - Phone:315-703-5050
Mailing Address - Fax:315-703-2424
Practice Address - Street 1:104 UNION AVE STE 804
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1844
Practice Address - Country:US
Practice Address - Phone:315-370-3505
Practice Address - Fax:315-703-2424
Is Sole Proprietor?:No
Enumeration Date:2014-03-28
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283007207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery