MEDICARE: SHEILA L MIRANDA M.D.

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	207R00000X	Internal Medicine Physician	11089	NV

General Provider Information

NPI Number	:	1699765735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEILA L MIRANDA M.D.

Provider Business Mailing Address
First Line	:	9811 W CHARLESTON BLVD
Second Line	:	SUITE 2543
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7528
Country	:	US
Telephone Number	:	702-433-6800
Fax Number	:	702-920-8850

Provider Business Practice Location Address
First Line	:	9811 W CHARLESTON BLVD
Second Line	:	SUITE 2543
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7528
Country	:	US
Telephone Number	:	702-433-6800
Fax Number	:	702-920-8850

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

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	11/08/2013

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