Provider Demographics
NPI:1316249154
Name:MUNOZ-PARIS, ILKAY (MD)
Entity type:Individual
Prefix:
First Name:ILKAY
Middle Name:
Last Name:MUNOZ-PARIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E. OAKLAND PARK BLVD SUITE 201 D
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334
Mailing Address - Country:US
Mailing Address - Phone:954-665-8318
Mailing Address - Fax:954-533-5198
Practice Address - Street 1:1400 E. OAKLAND PARK BLVD SUITE 201 D
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334
Practice Address - Country:US
Practice Address - Phone:954-665-8318
Practice Address - Fax:954-533-5198
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133NN1002X
ZZ82916207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education