MEDICARE: ALEX SARMEN MIRAKIAN

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	2085R0001X	Radiation Oncology Physician	ME158312	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01568224	OTHER	FL	RR MEDICARE
4	P02566934	OTHER	AL	RAILROAD MEDICARE
6	A98751A	OTHER	AL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	58061	OTHER	FL	BCBS
5	P938828	OTHER	FL	OPTIMUM
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	9811089	OTHER	FL	AETNA

General Provider Information

NPI Number	:	1598807778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX SARMEN MIRAKIAN

Provider Business Mailing Address
First Line	:	PO BOX 931176
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-1176
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3031 CARTERS MILL RD
Second Line	:
City	:	MARIANNA
State	:	FL
Zip	:	32446-1902
Country	:	US
Telephone Number	:	850-526-2104
Fax Number	:	850-482-2445

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

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	02/26/2026

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Directions to “ ALEX SARMEN MIRAKIAN ” Practice Location

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