Provider Demographics
NPI:1366143083
Name:MONROY GIAMUNDO, DANIEL JOSE
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOSE
Last Name:MONROY GIAMUNDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 UNIVERSITY PARK
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4434
Mailing Address - Country:US
Mailing Address - Phone:786-804-0844
Mailing Address - Fax:
Practice Address - Street 1:1106 CYPRESS GLEN CIR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7559
Practice Address - Country:US
Practice Address - Phone:407-627-0424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN277561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice