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General NPI Number Information
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NPI Number | 1528124534
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Entity Type | Individual
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Provider Name | JOSEPH MICHAEL MIRANDO MSPT
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Gender | Male
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 1501 N.W. 4 STREET 3RD FLOOR PROMONADE
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City | MIAMI
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State | FL
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Zip | 33125
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Country | US
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Telephone | 305-689-1700
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Fax | 305-644-3328
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Provider Business Mailing Address
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Address Line | 13625 SW 73RD CT
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City | PALMETTO BAY
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State | FL
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Zip | 33158-1209
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Country | US
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Telephone | 305-271-1309
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Fax | 305-644-3328
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT20125
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License Number State | FL
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