Provider Demographics
NPI:1194871277
Name:MUNIZ MOLINERO, CARLOS A SR (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:A
Last Name:MUNIZ MOLINERO
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 705
Mailing Address - Street 2:
Mailing Address - City:ANASW
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0705
Mailing Address - Country:US
Mailing Address - Phone:787-252-2165
Mailing Address - Fax:787-868-7258
Practice Address - Street 1:76 CALLE COLON
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3114
Practice Address - Country:US
Practice Address - Phone:787-252-2165
Practice Address - Fax:787-868-7258
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR11369207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR84233Medicare PIN
PRG43026Medicare UPIN