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General NPI Number Information
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NPI Number | 1902321946
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Entity Type | Individual
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Provider Name | ARMINDA ROSA MIRANDA
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Gender | Male
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Dates
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Enumeration Date | 08/10/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 450 DE LA CONSTITUCION AVE APT. 6-D
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City | SAN JUAN
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State | PR
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Zip | 00901
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Country | US
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Telephone | 787-409-4145
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Fax |
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Provider Business Mailing Address
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Address Line | 450 AVE DE LA CONSTITUCION APT 6D
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City | SAN JUAN
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State | PR
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Zip | 00901-2301
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Country | US
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Telephone | 787-409-4145
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 696
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License Number State | PR
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