Healthcare Provider Details

I. General information

NPI: 1881380715
Provider Name (Legal Business Name): ANNE MIRANDA BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26120 SW 146TH AVE
HOMESTEAD FL
33032-5342
US

IV. Provider business mailing address

26120 SW 146TH AVE
HOMESTEAD FL
33032-5342
US

V. Phone/Fax

Practice location:
  • Phone: 305-848-7310
  • Fax:
Mailing address:
  • Phone: 305-848-7310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2840584
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: