Provider Demographics
NPI:1255465563
Name:MIRANDA, ABEL (RESPIRATORY THERAPIS)
Entity type:Individual
Prefix:
First Name:ABEL
Middle Name:
Last Name:MIRANDA
Suffix:
Gender:M
Credentials:RESPIRATORY THERAPIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5598 W CALIMYRNA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-3100
Mailing Address - Country:US
Mailing Address - Phone:559-304-7619
Mailing Address - Fax:
Practice Address - Street 1:5598 W CALIMYRNA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-3100
Practice Address - Country:US
Practice Address - Phone:559-304-7619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25264227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified