Provider Demographics
NPI:1477094175
Name:MIRO, JOSE
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:MIRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:R
Other - Last Name:MIRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RRT
Mailing Address - Street 1:11995 SW 94TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2005
Mailing Address - Country:US
Mailing Address - Phone:305-970-4250
Mailing Address - Fax:
Practice Address - Street 1:11995 SW 94TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2005
Practice Address - Country:US
Practice Address - Phone:305-970-4250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT322227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered