Provider Demographics
NPI:1518788488
Name:MUNOZ DIAZ, PAOLA (DC)
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:
Last Name:MUNOZ DIAZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 BASES BLVD APT 501
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-6522
Mailing Address - Country:US
Mailing Address - Phone:787-233-3469
Mailing Address - Fax:
Practice Address - Street 1:710 CENTERVIEW BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7651
Practice Address - Country:US
Practice Address - Phone:689-202-4335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14113111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor