Provider Demographics
NPI:1689852147
Name:GERMAN CHAVES MUNOZ
Entity Type:Organization
Organization Name:GERMAN CHAVES MUNOZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:GERMAN
Authorized Official - Middle Name:CHAVES
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-259-8303
Mailing Address - Street 1:PO BOX 801196
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1196
Mailing Address - Country:US
Mailing Address - Phone:787-259-5303
Mailing Address - Fax:
Practice Address - Street 1:8159 CALLE CONCORDIA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1551
Practice Address - Country:US
Practice Address - Phone:787-259-8303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR051926OtherCA