Jose Miguel Miranda, MD

Individual provider Active NPI General Practice Physician · Jayuya, PR

NPI 1174724975 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1174724975
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
5672 (PR)
Practice address
Rd. 5141
KM. 0.5
Jayuya, PR 00664-0791
Phone
(787) 828-0869
Fax
(787) 828-0869
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5672PRMDGeneral Practice Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 5672 PR Yes

Addresses

Primary practice location

Rd. 5141
KM. 0.5
Jayuya, PR 00664-0791

Mailing address

PO Box 791
Jayuya, PR 00664-0791
Phone (787) 828-0869

Other providers in Jayuya, PR

All providers in Jayuya, PR · General Practice Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.