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General NPI Number Information
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NPI Number | 1023036365
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Entity Type | Individual
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Provider Name | PABLO ENRIQUE MIRANDA II D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 01/12/2018
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Provider Practice Location Address
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Address Line | 1050 NW 14TH ST
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City | MIAMI
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State | FL
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Zip | 33136-2105
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Country | US
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Telephone | 305-856-2300
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Fax | 305-856-0921
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Provider Business Mailing Address
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Address Line | 445 GRAND BAY DRIVE 210
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City | KEYBISCAYNE
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State | FL
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Zip | 33149
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Country | US
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Telephone | 305-856-2300
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Fax | 305-325-0935
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 15212
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License Number State | FL
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