MEDICARE: MARIA MIRANDA RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WA2000X	Administrator Registered Nurse	RN9645898	FL

General Provider Information

NPI Number	:	1043031503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA MIRANDA RN

Provider Business Mailing Address
First Line	:	3002 NW 7TH ST STE 3002B
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-4204
Country	:	US
Telephone Number	:	786-534-3289
Fax Number	:	786-534-3932

Provider Business Practice Location Address
First Line	:	3002 NW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-4204
Country	:	US
Telephone Number	:	786-534-3289
Fax Number	:	786-534-3932

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2024
Last Update Date	:	10/17/2024

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