Healthcare Provider Details

I. General information

NPI: 1558271916
Provider Name (Legal Business Name): MIRANDA NICOLE SPRINGFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22037 STATE ROAD 7
BOCA RATON FL
33428-4219
US

IV. Provider business mailing address

9458 BOCA RIVER CIR
BOCA RATON FL
33434-3970
US

V. Phone/Fax

Practice location:
  • Phone: 561-376-8430
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: