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General NPI Number Information
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NPI Number | 1881013225
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Entity Type | Organization
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Legal Business Name | DR. ANGEL MIRO DIAZ, PSC
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 04/14/2014
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Provider Practice Location Address
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Address Line | 369 CALLE DE DIEGO TORRE SAN FRANCISCO SUITE 507
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City | SAN JUAN
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State | PR
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Zip | 00923-3003
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Country | US
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Telephone | 787-282-3000
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Fax | 787-282-3080
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Provider Business Mailing Address
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Address Line | PO BOX 29586
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City | SAN JUAN
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State | PR
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Zip | 00929-0586
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Country | US
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Telephone | 787-282-3000
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Fax | 787-282-3080
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. ANGEL J MIRO
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Credential | M.D.
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Telephone | 787-282-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 9630
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License Number State | PR
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