Healthcare Provider Details

I. General information

NPI: 1780507319
Provider Name (Legal Business Name): RAISA DE LA CARIDAD BRANA MIRANDA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR PR 506 KM 1.0 BO COTO LAUREL
PONCE PR
00780
US

IV. Provider business mailing address

CARR PR 506 KM 1.0 BO COTO LAUREL
PONCE PR
00780
US

V. Phone/Fax

Practice location:
  • Phone: 787-434-1700
  • Fax:
Mailing address:
  • Phone: 787-434-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number17935-I
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: