Provider Demographics
NPI:1407058274
Name:MIRANDA, YANIRA (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MRS
First Name:YANIRA
Middle Name:
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EDIF 68
Mailing Address - Street 2:APT #688 RAMOS ANTONINI
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924
Mailing Address - Country:US
Mailing Address - Phone:787-760-1280
Mailing Address - Fax:787-283-3673
Practice Address - Street 1:CARR. 176 ESQINA SAN CLAUDIO 352
Practice Address - Street 2:
Practice Address - City:CUPEY
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-760-1280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5634183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician