Provider Demographics
NPI:1811236730
Name:MIRRA HEALTH CARE LLC
Entity type:Organization
Organization Name:MIRRA HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PARIKSITH
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-799-0046
Mailing Address - Street 1:14690 SPRING HILL DR
Mailing Address - Street 2:101
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-799-0046
Mailing Address - Fax:352-799-0048
Practice Address - Street 1:14690 SPRING HILL DR
Practice Address - Street 2:101
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-8102
Practice Address - Country:US
Practice Address - Phone:352-799-0046
Practice Address - Fax:352-799-0048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization