MEDICARE: VINCENT P. MIRAGLIA, MD, PA

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	174400000X	Specialist

General Provider Information

NPI Number	:	1669418620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VINCENT P. MIRAGLIA, MD, PA

Provider Business Mailing Address
First Line	:	2398 SE OCEAN BLVD STE A
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34996-3310
Country	:	US
Telephone Number	:	772-223-2864
Fax Number	:	772-223-2861

Provider Business Practice Location Address
First Line	:	2398 SE OCEAN BLVD STE A
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34996-3310
Country	:	US
Telephone Number	:	772-223-2864
Fax Number	:	772-223-2861

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. VINCENT P MIRAGLIA
Credential	:	MD
Telephone Number	:	772-223-2864

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	11/19/2008

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