Provider Demographics
NPI:1780102566
Name:MUNOZ, JUAN CARLOS (DC)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:CARLOS
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 NE 167TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3404
Mailing Address - Country:US
Mailing Address - Phone:305-651-8100
Mailing Address - Fax:305-651-2241
Practice Address - Street 1:177 NE 167TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3404
Practice Address - Country:US
Practice Address - Phone:305-651-8100
Practice Address - Fax:305-651-2241
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11256111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor