Provider Demographics
NPI:1154193654
Name:MUNIZ CORTES, YESENIA
Entity type:Individual
Prefix:
First Name:YESENIA
Middle Name:
Last Name:MUNIZ CORTES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CALLE ESPERANZA
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-8707
Mailing Address - Country:US
Mailing Address - Phone:787-243-4023
Mailing Address - Fax:
Practice Address - Street 1:AVE MUNOZ RIVERA EDIFICIO 309
Practice Address - Street 2:BO PUENTE SECTOR ALCANTARILLA
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-915-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2355S0801X
PR616612355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty