Provider Demographics
NPI:1750564332
Name:MUNIZ BRUNET, MARIALMA
Entity type:Individual
Prefix:
First Name:MARIALMA
Middle Name:
Last Name:MUNIZ BRUNET
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:MARIALMA
Other - Middle Name:
Other - Last Name:MUNIZ BRUNET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 435
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0435
Mailing Address - Country:US
Mailing Address - Phone:787-826-2526
Mailing Address - Fax:787-826-2526
Practice Address - Street 1:STREET 402 KM 2.0
Practice Address - Street 2:BARRIO MARIAS
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-0435
Practice Address - Country:US
Practice Address - Phone:787-826-2526
Practice Address - Fax:787-826-2526
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR016938208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1750564332Medicare UPIN