Provider Demographics
NPI:1184273997
Name:MUNOZ ZAPATA, PRISCILA
Entity type:Individual
Prefix:
First Name:PRISCILA
Middle Name:
Last Name:MUNOZ ZAPATA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MARGINAL SANTA CRUZ C-17
Mailing Address - Street 2:URB. SANTA CRUZ
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-523-3113
Mailing Address - Fax:787-786-8690
Practice Address - Street 1:MARGINAL SANTA CRUZ C-17
Practice Address - Street 2:URB. SANTA CRUZ
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-523-3113
Practice Address - Fax:787-786-8690
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000315-P.A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR000315-P.A.OtherPHYSICIAN ASSISTANT