MEDICARE: DAVID MIRANDA 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
1	2086S0102X	Surgical Critical Care Physician	1024243	MA
2	208600000X	Surgery Physician	1024243	MA

General Provider Information

NPI Number	:	1275987299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MIRANDA M.D.

Provider Business Mailing Address
First Line	:	1959 NE PACIFIC ST
Second Line	:	SUITE BB-487
City	:	SEATTLE
State	:	WA
Zip	:	98195-6410
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1959 NE PACIFIC ST
Second Line	:	SUITE BB-487
City	:	SEATTLE
State	:	WA
Zip	:	98195-6410
Country	:	US
Telephone Number	:	206-543-3680
Fax Number	:

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

Provider Enumeration Date	:	04/15/2016
Last Update Date	:	01/14/2026

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Directions to “ DAVID MIRANDA M.D.” Practice Location

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