Healthcare Provider Details

I. General information

NPI: 1598320202
Provider Name (Legal Business Name): EMANUEL A DE MIRANDA-SANCHEZ MD, MSMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

QUADRANGLE MEDICAL CENTER AVE. LUIS MUNOZ MARIN, SUITE 205
CAGUAS PR
00725
US

IV. Provider business mailing address

QUADRANGLE MEDICAL CENTER SUITE 205 AVE. LUIS MUNOZ MAR
CAGUAS PR
00725
US

V. Phone/Fax

Practice location:
  • Phone: 787-244-7611
  • Fax:
Mailing address:
  • Phone: 787-244-7611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number60940
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number22749
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: