DataLabs

datalabs.health made in the usa

Contact us Sign in | Documentation |

divider

Medicare/Medicaid Verification Programs divider

divider

Medicare Verification Program divider

divider

1104815117

NPI Code Detail

MEDICARE: DR. ALEX ALEXANDER AGOSTINI-MIRANDA MD

MEDICARE: DR. ALEX ALEXANDER AGOSTINI-MIRANDA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	43934	IA
2	207P00000X	Emergency Medicine Physician	76009	MN
3	207P00000X	Emergency Medicine Physician	E-7802	AR
4	207P00000X	Emergency Medicine Physician	MD0000039280	TN
5	207P00000X	Emergency Medicine Physician	MD.30950	AL
6	207P00000X	Emergency Medicine Physician	44351	KY
7	207P00000X	Emergency Medicine Physician	20002	ND
8	207Q00000X	Family Medicine Physician	MD.30950	AL
9	207Q00000X	Family Medicine Physician	76009	MN
10	207Q00000X	Family Medicine Physician	20002	ND
11	207Q00000X	Family Medicine Physician	43934	IA
12	207Q00000X	Family Medicine Physician	ME95555	FL
13	207Q00000X	Family Medicine Physician	MD0000039280	TN
14	207Q00000X	Family Medicine Physician	44351	KY
15	207P00000X	Emergency Medicine Physician	ME95555	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104815117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEX ALEXANDER AGOSTINI-MIRANDA MD

Provider Business Mailing Address
First Line	:	2101 ELM ST N
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-2417
Country	:	US
Telephone Number	:	701-232-3241
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 ELM ST N
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58102-2417
Country	:	US
Telephone Number	:	701-232-3241
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	04/25/2025

Similar Medicare Providers

1497363154 — DR. ISAAC NIES PHARMD, BCPS, BCOP
Practice Location Address:

2101 ELM ST N
FARGO, ND
58102-2417

Practice Phone: 701-239-3700
Practice Fax:

1104763291 — RACHEL LEIN
Practice Location Address:

2101 ELM ST N
FARGO, ND
58102-2417

Practice Phone: 701-237-3241
Practice Fax:

1467335059 — AMIE LYNN BOELKE RN, BSN
Practice Location Address:

2101 ELM ST N
FARGO, ND
58102-2417

Practice Phone: 701-232-3241
Practice Fax:

1255140117 — MRS. BARBARA LYNN HOFF RN
Practice Location Address:

2101 ELM ST N
FARGO, ND
58102-2417

Practice Phone: 701-232-3241
Practice Fax:

1376366575 — BETHANY A DIXON RN
Practice Location Address:

2101 ELM ST N
FARGO, ND
58102-2417

Practice Phone: 701-239-3700
Practice Fax: 701-239-3777

1518960301 — PAUL SHEARER DPM
Practice Location Address:

2101 ELM ST N
FARGO, ND
58102-2417

Practice Phone: 701-232-3241
Practice Fax:

1437143427 — DR. ADAM JOHN GLAZIER M.D.
Practice Location Address:

2101 ELM ST N
FARGO, ND
58102-2417

Practice Phone: 701-239-3700
Practice Fax:

Directions to “ DR. ALEX ALEXANDER AGOSTINI-MIRANDA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.