Individual provider Active NPI

Eduardo Miralles, M.D.

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1083695191
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
15995 Issued in PR
Practice address
1395 Calle San Rafael
San Juan, PR 00910-3428
Phone
(787) 723-2950
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 15995 PR Primary

Addresses

Primary practice location

1395 Calle San Rafael
San Juan, PR 00910-3428

Mailing address

Cond Los Robles
Apto 609a
San Juan, PR 00927-4631
Phone (787) 314-4895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000456 PR Practitioner - General Practice 8426063868 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

858 Ave San Patricio
San Juan, PR 00921-1308
Phone (787) 782-7060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15995PRMDGeneral Practice Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1083695191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND LOS ROBLES",
            "address_2": "APTO 609A",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009274631",
            "telephone_number": "787-314-4895",
            "fax_number": "787-274-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 CALLE SAN RAFAEL",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009103428",
            "telephone_number": "787-723-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRALLES",
        "first_name": "EDUARDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.