Basic Information
| Provider Information | |||||||||
| NPI: | 1174752877 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUNOZ MENDOZA | ||||||||
| FirstName: | JAIR | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 NW 12TH AVE | ||||||||
| Address2: | E-1007 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331361051 | ||||||||
| CountryCode: | US | ||||||||
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| FaxNumber: | 3052434664 | ||||||||
| Practice Location | |||||||||
| Address1: | 1120 NW 14TH STREET, SUITE 360 | ||||||||
| Address2: | U MIAMI, DIVISION OF NEPHROLOGY, CLINICAL RESEARCH BLDG | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052436251 | ||||||||
| FaxNumber: | 3052433506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2009 | ||||||||
| LastUpdateDate: | 11/30/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A103091 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | ME107413 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.