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General NPI Number Information
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NPI Number | 1174246615
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Entity Type | Individual
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Provider Name | JULIANNA MIRANDA
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Gender | Female
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 2305 GLENWOOD DR
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City | WINTER PARK
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State | FL
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Zip | 32792-3313
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Country | US
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Telephone | 407-908-5373
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Fax |
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Provider Business Mailing Address
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Address Line | 3314 ARDEN VILLAS BLVD APT 3-0124
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City | ORLANDO
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State | FL
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Zip | 32817-2180
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Country | US
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Telephone | 561-779-7904
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Fax |
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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