Provider Demographics
NPI:1801081252
Name:RAFAEL A MUNNE MD PA
Entity type:Organization
Organization Name:RAFAEL A MUNNE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:SCHAAL-MUNNE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:772-323-4418
Mailing Address - Street 1:2318 NW BAY COLONY CT
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-9129
Mailing Address - Country:US
Mailing Address - Phone:772-323-4418
Mailing Address - Fax:
Practice Address - Street 1:2318 NW BAY COLONY CT
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-9129
Practice Address - Country:US
Practice Address - Phone:772-323-4418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes283Q00000XHospitalsPsychiatric HospitalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275140200Medicaid