Provider Demographics
NPI:1841494531
Name:MUNIZ-HELM, MAYRA LYZETTE (MD)
Entity type:Individual
Prefix:DR
First Name:MAYRA
Middle Name:LYZETTE
Last Name:MUNIZ-HELM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MAYRA
Other - Middle Name:LYZETTE
Other - Last Name:MUNIZ-ORTIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11156 CANAL RD STE A
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-5816
Mailing Address - Country:US
Mailing Address - Phone:513-772-6166
Mailing Address - Fax:
Practice Address - Street 1:11156 CANAL RD STE A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-5816
Practice Address - Country:US
Practice Address - Phone:513-772-6166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 0690542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0225354Medicaid
OH0203532Medicaid