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NPI Code Detail

MEDICARE: DR. ALLEN PAUL MIRAFLOR M.D.

MEDICARE: DR. ALLEN PAUL MIRAFLOR M.D.
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
1207ZD0900XDermatopathology (Pathology) PhysicianA152557CA
2207ZD0900XDermatopathology (Pathology) Physician68605AZ

General Provider Information

NPI Number : 1144587098
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALLEN PAUL MIRAFLOR M.D.
Provider Business Mailing Address
First Line : PO BOX 245106
Second Line :
City : TUCSON
State : AZ
Zip : 85724-5106
Country : US
Telephone Number : 520-694-0111
Fax Number : 520-626-2521
Provider Business Practice Location Address
First Line : 1625 N CAMPBELL AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85719-4330
Country : US
Telephone Number : 520-694-0111
Fax Number : 520-626-2521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2012
Last Update Date : 12/01/2025

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