Basic Information
Provider Information
NPI: 1811030430
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MUENZ
FirstName: JOHN
MiddleName: ARTHUR
NamePrefix: DR.
NameSuffix: JR.
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 705 WELLS RD STE 300
Address2:  
City: ORANGE PARK
State: FL
PostalCode: 320732982
CountryCode: US
TelephoneNumber: 9042826331
FaxNumber: 9046191080
Practice Location
Address1: 14011 BEACH BLVD STE 120
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 322501695
CountryCode: US
TelephoneNumber: 9042236400
FaxNumber: 9042236420
Other Information
ProviderEnumerationDate: 02/14/2007
LastUpdateDate: 08/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208100000XME49540FLN Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 
207Q00000XME49540FLY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
00548850005FL MEDICAID


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