Individual
MR. MARIO R MUNOZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5301 E GRANT RD, ORTHOPAEDIC BLDG, 1ST FLOOR, TUCSON, AZ 85712-2805
(520) 784-6200
(520) 784-6109
Mailing address
PO BOX 31630, TUCSON, AZ 85751-1630
(520) 784-6200
(520) 784-6109
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2004-0038
NM
363A00000X
Physician Assistant
Primary
3490
AZ
363AM0700X
Medical Physician Assistant
3490
AZ
363AS0400X
Surgical Physician Assistant
3490
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
523112
—
AZ
Enumeration date
11/06/2006
Last updated
01/14/2016
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