MEDICARE: MARIA NELA RIVERA MIRANDA SA-C

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	246ZC0007X	Surgical Assistant	20-376	FL

General Provider Information

NPI Number	:	1285334797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA NELA RIVERA MIRANDA SA-C

Provider Business Mailing Address
First Line	:	2111 SOLE MIA WAY
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-2311
Country	:	US
Telephone Number	:	305-243-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2111 SOLE MIA WAY
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-2311
Country	:	US
Telephone Number	:	305-243-4000
Fax Number	:

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

Provider Enumeration Date	:	03/06/2023
Last Update Date	:	09/02/2025

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