Provider Demographics
NPI:1457628588
Name:FRANCISCO MIRANDA MD PA
Entity Type:Organization
Organization Name:FRANCISCO MIRANDA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-389-4143
Mailing Address - Street 1:11880 SW 40 ST
Mailing Address - Street 2:401
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3575
Mailing Address - Country:US
Mailing Address - Phone:305-389-4143
Mailing Address - Fax:305-220-0610
Practice Address - Street 1:11880 SW 40 ST
Practice Address - Street 2:401
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3575
Practice Address - Country:US
Practice Address - Phone:305-389-4143
Practice Address - Fax:305-220-0610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 58018207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty