MEDICARE: MR. CARLOS RAMON MIRANDA

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	10	NY

General Provider Information

NPI Number	:	1396678942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARLOS RAMON MIRANDA

Provider Business Mailing Address
First Line	:	229 TROY AVE APT 8
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11213-3640
Country	:	US
Telephone Number	:	347-319-8114
Fax Number	:

Provider Business Practice Location Address
First Line	:	229 TROY AVE APT 8
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11213-3640
Country	:	US
Telephone Number	:	347-319-8114
Fax Number	:

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

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ MR. CARLOS RAMON MIRANDA ” Practice Location

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