Provider Demographics
NPI:1487774923
Name:MAUNEZ, TOMAS IV (MED LPC, RN-BSN)
Entity type:Individual
Prefix:MR
First Name:TOMAS
Middle Name:
Last Name:MAUNEZ
Suffix:IV
Gender:M
Credentials:MED LPC, RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 787
Mailing Address - Street 2:
Mailing Address - City:NAGUABO
Mailing Address - State:PR
Mailing Address - Zip Code:00718-0787
Mailing Address - Country:US
Mailing Address - Phone:787-310-2039
Mailing Address - Fax:
Practice Address - Street 1:3 CALLE L-16 DIPLO
Practice Address - Street 2:
Practice Address - City:NAGUABO
Practice Address - State:PR
Practice Address - Zip Code:00718-0787
Practice Address - Country:US
Practice Address - Phone:787-310-2039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR76444G163W00000X, 163WA0400X, 163WP0808X, 163WS0200X
PR101Y00000X, 101YA0400X, 101YM0800X, 101YP1600X, 101YS0200X
PR1163101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No163W00000XNursing Service ProvidersRegistered Nurse
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR58491OtherCOLEGIO DE PROFESIONALES DE ENFERMERIA DE PUERTO RICO
PR764444GOtherPUERTO RICO DEPARTMENT OF HEALTH - NURSE LIC.
PRLPC 1163OtherPUERTO RICO DEPARTMENT OF HEALTH - COUNSELOR LIC.