Provider Demographics
NPI:1710456181
Name:MUNOZ, YADIEL (MSW)
Entity Type:Individual
Prefix:
First Name:YADIEL
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 LAKE BRIDGE LN APT 611
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-5780
Mailing Address - Country:US
Mailing Address - Phone:786-426-1480
Mailing Address - Fax:
Practice Address - Street 1:5786, 225 S SWOOPE AVE # 211,
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751
Practice Address - Country:US
Practice Address - Phone:407-622-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health