Provider Demographics
NPI:1053091025
Name:MUNIZ, BRYCE NOELLE
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:NOELLE
Last Name:MUNIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 PECAN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-5186
Mailing Address - Country:US
Mailing Address - Phone:941-237-9197
Mailing Address - Fax:
Practice Address - Street 1:8270 BURNT STORE RD
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-4705
Practice Address - Country:US
Practice Address - Phone:941-456-0018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician