Healthcare Provider Details

I. General information

NPI: 1326956467
Provider Name (Legal Business Name): MIRANDA FIGUEREDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3209 CYPRESS GROVE DR
EUSTIS FL
32736-2503
US

IV. Provider business mailing address

160 SERENITY LOOP APT 203
LAKE WALES FL
33859-6896
US

V. Phone/Fax

Practice location:
  • Phone: 762-224-2083
  • Fax: 973-888-1377
Mailing address:
  • Phone: 863-220-4574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: