Provider Demographics
NPI:1063184224
Name:ALBERTO MUNOZ, VICTOR MANUEL
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:MANUEL
Last Name:ALBERTO MUNOZ
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 1:6820 N AUGUSTA DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2118
Mailing Address - Country:US
Mailing Address - Phone:786-307-9711
Mailing Address - Fax:
Practice Address - Street 1:7838 NW 178TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3649
Practice Address - Country:US
Practice Address - Phone:786-307-9711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21-186928106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician