Healthcare Provider Details

I. General information

NPI: 1063552008
Provider Name (Legal Business Name): JULIO A. MIRANDA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JULIO MIRANDA SANCHEZ MD

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 MAIN STREET 2ND FL, SUITE B
SPRINGFIELD MA
01107-1112
US

IV. Provider business mailing address

280 CHESTNUT ST FL 2
SPRINGFIELD MA
01199-1001
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-7330
  • Fax: 413-794-8163
Mailing address:
  • Phone: 413-794-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number262495
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number262495
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: