Provider Demographics
NPI:1265171771
Name:MUNOZ-MIRO, HECTOR ALEXIS
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:ALEXIS
Last Name:MUNOZ-MIRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. SABANA GARDENS
Mailing Address - Street 2:16-15 CALLE 21
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-2920
Mailing Address - Country:US
Mailing Address - Phone:787-215-5293
Mailing Address - Fax:
Practice Address - Street 1:URB. SABANA GARDENS
Practice Address - Street 2:16-15 CALLE 21
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-2920
Practice Address - Country:US
Practice Address - Phone:787-215-5293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR17175208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program