Provider Demographics
NPI:1962917328
Name:MUNOZ, ROBER EFRAIN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:ROBER
Middle Name:EFRAIN
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 N BAYSHORE DR APT 1440
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-1151
Mailing Address - Country:US
Mailing Address - Phone:305-807-5670
Mailing Address - Fax:305-577-8187
Practice Address - Street 1:1717 N BAYSHORE DR APT 1440
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1151
Practice Address - Country:US
Practice Address - Phone:305-807-5670
Practice Address - Fax:305-577-8187
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15869225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty