Provider Demographics
NPI:1093510919
Name:MUNOZ, EDENID MARIA (TCM)
Entity type:Individual
Prefix:
First Name:EDENID
Middle Name:MARIA
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:TCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 E MAIN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-4241
Mailing Address - Country:US
Mailing Address - Phone:407-476-8086
Mailing Address - Fax:
Practice Address - Street 1:651 E MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-4241
Practice Address - Country:US
Practice Address - Phone:407-476-8086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator