Healthcare Provider Details

I. General information

NPI: 1609770569
Provider Name (Legal Business Name): YESSICA ALTAMIRANO MIRANDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1869 W FLAGLER ST
MIAMI FL
33135-1939
US

IV. Provider business mailing address

1869 W FLAGLER ST
MIAMI FL
33135-1939
US

V. Phone/Fax

Practice location:
  • Phone: 786-806-9187
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: