Provider Demographics
NPI:1730479791
Name:MIRANDA, JULIE ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 E HWY 50
Mailing Address - Street 2:STE 106
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-8411
Mailing Address - Country:US
Mailing Address - Phone:352-242-2560
Mailing Address - Fax:352-404-7979
Practice Address - Street 1:2560 E HWY 50
Practice Address - Street 2:UNIT 106
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-8411
Practice Address - Country:US
Practice Address - Phone:352-242-2560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10261111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor