MEDICARE: MARILYN MIRALLES

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	251B00000X	Case Management Agency		FL

General Provider Information

NPI Number	:	1770803975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILYN MIRALLES

Provider Business Mailing Address
First Line	:	2016 BAY DR PH 905
Second Line	:	MIAMI PHYSICAL THERAPY, CORP
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141
Country	:	US
Telephone Number	:	305-300-9454
Fax Number	:

Provider Business Practice Location Address
First Line	:	2016 BAY DR APT 905
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-4422
Country	:	US
Telephone Number	:	305-300-9454
Fax Number	:

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

Provider Enumeration Date	:	06/10/2010
Last Update Date	:	06/10/2010

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Directions to “ MARILYN MIRALLES ” Practice Location

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