Provider Demographics
NPI:1063828143
Name:GIUSTI, MIRANDA (DO)
Entity Type:Individual
Prefix:DR
First Name:MIRANDA
Middle Name:
Last Name:GIUSTI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 OAK MANOR LN APT 46
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-1214
Mailing Address - Country:US
Mailing Address - Phone:727-489-3305
Mailing Address - Fax:727-499-9559
Practice Address - Street 1:3600 OAK MANOR LN APT 46
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-1214
Practice Address - Country:US
Practice Address - Phone:727-489-3305
Practice Address - Fax:727-499-9559
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2016-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13285207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIP727ZMedicare PIN