Provider Demographics
NPI:1528478377
Name:MUNIZ, NIRVANA
Entity type:Individual
Prefix:
First Name:NIRVANA
Middle Name:
Last Name:MUNIZ
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 1:112 RESERVE CIR APT 104
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8085
Mailing Address - Country:US
Mailing Address - Phone:407-575-0815
Mailing Address - Fax:
Practice Address - Street 1:1035 S SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-5526
Practice Address - Country:US
Practice Address - Phone:407-678-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical