Provider Demographics
NPI:1689886525
Name:MIRANDA, ADA SMYRNA (MD)
Entity Type:Individual
Prefix:DR
First Name:ADA
Middle Name:SMYRNA
Last Name:MIRANDA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:VILLAS DEL CAPITAN SOLANDRA AA 18 BUZON 38
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-879-0732
Mailing Address - Fax:787-879-0732
Practice Address - Street 1:HOSPITAL METROPOLITANO DR. SUSONI
Practice Address - Street 2:CALLE PALMA
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-650-1030
Practice Address - Fax:787-650-1040
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PR54122080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5412OtherSTATE LICENSE