Provider Demographics
NPI:1023005204
Name:MIRANDA, FRANCISCO (MD)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:MIRANDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11880 SW 40TH ST
Mailing Address - Street 2:STE 401
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3584
Mailing Address - Country:US
Mailing Address - Phone:305-220-0220
Mailing Address - Fax:305-220-0610
Practice Address - Street 1:7306 SW 117TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-3804
Practice Address - Country:US
Practice Address - Phone:305-220-0220
Practice Address - Fax:866-285-7068
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME58018207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373286000Medicaid
23368AMedicare ID - Type Unspecified
FL373286000Medicaid