Provider Demographics
NPI:1841189511
Name:MUNIZ, KEVIN YASSER
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:YASSER
Last Name:MUNIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BO GUANIQUILLA CALLE A 265
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-4025
Mailing Address - Country:US
Mailing Address - Phone:787-964-7614
Mailing Address - Fax:
Practice Address - Street 1:BO GUANIQUILLA CALLE A 265
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-4025
Practice Address - Country:US
Practice Address - Phone:787-964-7614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR167301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical