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General NPI Number Information
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NPI Number | 1215504568
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Entity Type | Individual
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Provider Name | KRISTIN MIRANDA APRN
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Gender | Female
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 01/19/2025
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Provider Practice Location Address
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Address Line | 737 STIRLING CENTER PL STE 1809
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City | LAKE MARY
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State | FL
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Zip | 32746-5715
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Country | US
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Telephone | 407-878-6008
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Fax |
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Provider Business Mailing Address
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Address Line | 425 S HUNT CLUB BLVD STE 1051
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City | APOPKA
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State | FL
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Zip | 32703-2428
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Country | US
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Telephone | 407-786-4080
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Fax | 407-786-4667
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | APRN11008304
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License Number State | FL
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