Provider Demographics
NPI:1770834913
Name:MUNOZ, CARMEN M (MSW)
Entity Type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:M
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:CARMEN
Other - Middle Name:M
Other - Last Name:MUNOZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 2416
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32721-2416
Mailing Address - Country:US
Mailing Address - Phone:386-479-3017
Mailing Address - Fax:
Practice Address - Street 1:1805 LANDING DR APT D
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-6707
Practice Address - Country:US
Practice Address - Phone:386-479-3017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW 63741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical