Provider Demographics
NPI:1174752877
Name:MUNOZ MENDOZA, JAIR (MD)
Entity type:Individual
Prefix:
First Name:JAIR
Middle Name:
Last Name:MUNOZ MENDOZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1500 NW 12TH AVE
Mailing Address - Street 2:E-1007
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1051
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:305-243-4664
Practice Address - Street 1:1120 NW 14TH STREET, SUITE 360
Practice Address - Street 2:U MIAMI, DIVISION OF NEPHROLOGY, CLINICAL RESEARCH BLDG
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-243-6251
Practice Address - Fax:305-243-3506
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2010-11-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA103091207R00000X
FLME107413207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine