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Provider Information for 1710456181


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YADIEL MUNOZ MSW


Sex: Male

NPI: 1710456181
Last Updated: 2018-11-15
Certification Date:

Details

NameValue
NPI1710456181
Enumeration Date2018-11-15
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 456 LAKE BRIDGE LN APT 611
APOPKA, FL 32703-5780
United States

Phone: 786-426-1480 | Fax:
 
Primary Practice Address 5786, 225 S SWOOPE AVE # 211,
MAITLAND, FL 32751
United States

Phone: 407-622-0444 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental Health