Provider Demographics
NPI:1417386517
Name:MUNOZ, MARCOS ENMANUEL (DPT)
Entity type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:ENMANUEL
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 NE 2ND ST
Mailing Address - Street 2:APT 425
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-2289
Mailing Address - Country:US
Mailing Address - Phone:305-588-9064
Mailing Address - Fax:
Practice Address - Street 1:18001 COLLINS AVE
Practice Address - Street 2:2ND FLOOR, SPA
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160
Practice Address - Country:US
Practice Address - Phone:305-588-9064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT28676225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist