Provider Demographics
NPI:1417402330
Name:MIRO CO, ADRIAN AURELIO (MD)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:AURELIO
Last Name:MIRO CO
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 1:100 PR-682 #831
Mailing Address - Street 2:GARROCHALES
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00652
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:155-199 CALLE ARIZMENDI
Practice Address - Street 2:
Practice Address - City:FLORIDA
Practice Address - State:PR
Practice Address - Zip Code:00650
Practice Address - Country:US
Practice Address - Phone:787-822-2170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-20
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22941208D00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice