Provider Demographics
NPI:1801094339
Name:MUNOZ, AVILIO JESUS (AP)
Entity type:Individual
Prefix:DR
First Name:AVILIO
Middle Name:JESUS
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15289 AMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2155
Mailing Address - Country:US
Mailing Address - Phone:813-975-9690
Mailing Address - Fax:813-676-0852
Practice Address - Street 1:15289 AMBERLY DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2155
Practice Address - Country:US
Practice Address - Phone:813-975-9690
Practice Address - Fax:813-676-0852
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1998171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist