Provider Demographics
NPI:1215936505
Name:MUNIZ, JOSE RADAMES (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:RADAMES
Last Name:MUNIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSE
Other - Middle Name:R
Other - Last Name:MUNIZ MELENDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 372139
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-2139
Mailing Address - Country:US
Mailing Address - Phone:787-263-3138
Mailing Address - Fax:787-263-2205
Practice Address - Street 1:10 AVE MIGUEL MELENDEZ MUNOZ
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4609
Practice Address - Country:US
Practice Address - Phone:787-263-3138
Practice Address - Fax:787-263-2205
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7535207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE16917Medicare UPIN
PR2-9098Medicare ID - Type Unspecified