Basic Information
| Provider Information | |||||||||
| NPI: | 1932515392 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUNIZ MARTINEZ | ||||||||
| FirstName: | ANDRES | ||||||||
| MiddleName: | RAFAEL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | MANSIONES DE GUAYNABO | ||||||||
| Address2: | CALLE 5 F1 | ||||||||
| City: | GUAYNABO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00969 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7875351001 | ||||||||
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| Practice Location | |||||||||
| Address1: | EDIFICIO PROFESIONAL MENONITA DE CAYEY | ||||||||
| Address2: | SUITE 305 | ||||||||
| City: | CAYEY | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7875351001 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2014 | ||||||||
| LastUpdateDate: | 06/09/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 278143 | MA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 21543 | PR | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.