Provider Demographics
NPI:1013438142
Name:MUNOZ, MEGAN N (MA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:N
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13924 OCEAN PINE CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7441
Mailing Address - Country:US
Mailing Address - Phone:321-318-1412
Mailing Address - Fax:
Practice Address - Street 1:1850 LEE RD STE 250
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2116
Practice Address - Country:US
Practice Address - Phone:407-647-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH16090101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health