Vincent S. Munizza, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2064 Issued in FL

Practice address

13650 Metropolis Ave
Suite 101
Fort Myers, FL 33912

Phone

(239) 768-2111

Fax

(239) 482-4404

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: vmunizza@icpeds.opdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Island Coast Pediatrics

  • Pediatrics Physician
  • Fort Myers, FL
  • NPI 1215962386
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1457309601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12550 PROFESSIONAL PARK DR.",
            "address_2": "SUITE 11",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33913",
            "telephone_number": "239-768-2111",
            "fax_number": "239-482-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13650 METROPOLIS AVE",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33912",
            "telephone_number": "239-768-2111",
            "fax_number": "239-482-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNIZZA",
        "first_name": "VINCENT",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "PA2064",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2064",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA2064",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290123400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathneal G Mulugeta, PHARMD
• Christopher Hugh Mulvey, DPT
• Johanna Mulvihill, B.S.
• Elizabeth Muniz, LMHC, RPT-S
• Olivia Munizza, MD
• Anisleidys Munoz, MD
• Chris Munoz, PA-C
• Diane Munoz
• Linda Jean Munroe, APRN
• Sharon Munsey, ARNP

• Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.