MEDICARE: MAILY BETANCOURT MIRANDA SA-C

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	246ZC0007X	Surgical Assistant	26-141	FL

General Provider Information

NPI Number	:	1760336994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAILY BETANCOURT MIRANDA SA-C

Provider Business Mailing Address
First Line	:	1250 W 30TH ST APT 9
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4847
Country	:	US
Telephone Number	:	305-778-8922
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 W 30TH ST APT 9
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4847
Country	:	US
Telephone Number	:	305-778-8922
Fax Number	:

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

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	02/24/2026

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Directions to “ MAILY BETANCOURT MIRANDA SA-C” Practice Location

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