Provider Demographics
NPI:1598320202
Name:DE MIRANDA-SANCHEZ, EMANUEL A (MD, MSMS)
Entity Type:Individual
Prefix:DR
First Name:EMANUEL
Middle Name:A
Last Name:DE MIRANDA-SANCHEZ
Suffix:
Gender:M
Credentials:MD, MSMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RECINTO DE CIENCIAS MEDICAS, DEPARTAMENTO DE CIRUGIA
Mailing Address - Street 2:PASEO DR. JOSE CELSO BARBOSA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:
Practice Address - Street 1:RECINTO DE CIENCIAS MEDICAS, DEPARTAMENTO DE CIRUGIA
Practice Address - Street 2:PASEO DR. JOSE CELSO BARBOSA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-08
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22749208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice