Provider Demographics
NPI:1932632742
Name:MUNIZ CASTRO, HANNAH MARIE MIRASOL (MD)
Entity Type:Individual
Prefix:
First Name:HANNAH MARIE
Middle Name:MIRASOL
Last Name:MUNIZ CASTRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47474 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-8846
Mailing Address - Country:US
Mailing Address - Phone:760-469-5213
Mailing Address - Fax:
Practice Address - Street 1:47474 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-8846
Practice Address - Country:US
Practice Address - Phone:760-469-5213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA186124207W00000X, 207WX0120X
FLME149163207W00000X
TXT5401207WX0120X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program