Individual provider Active NPI

Kristin Miranda, APRN

  • Family Medicine Physician
  • Lake Mary, FL
National Provider Identifier
1215504568
Registry record updated Jan 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
APRN11008304 Issued in FL
Practice address
737 Stirling Center PL Ste 1809
Lake Mary, FL 32746-5715
Phone
(407) 878-6008
NPI assigned
Jun 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X APRN11008304 FL Primary

Addresses

Primary practice location

737 Stirling Center PL Ste 1809
Lake Mary, FL 32746-5715

Mailing address

425 S Hunt Club Blvd Ste 1051
Apopka, FL 32703-2428
Phone (407) 786-4080

Other practice location 1

425 S Hunt Club Blvd Ste 1051
Apopka, FL 32703-2428
Phone (407) 786-4080

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APRN11008304FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Huntclub Pediatric Associates, LLC PastSince Jan 26, 2025 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHAADD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737244800000",
    "number": "1215504568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S HUNT CLUB BLVD STE 1051",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327032428",
            "telephone_number": "407-786-4080",
            "fax_number": "407-786-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 STIRLING CENTER PL STE 1809",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465715",
            "telephone_number": "407-878-6008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 S Hunt Club Blvd Ste 1051",
            "address_purpose": "LOCATION",
            "city": "Apopka",
            "state": "FL",
            "postal_code": "327032428",
            "country_code": "US",
            "telephone_number": "407-786-4080",
            "fax_number": "407-786-4667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "KRISTIN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2025-01-19",
        "certification_date": "2025-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "APRN11008304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.