Active NPI
Elton Gene Miranda, APRN
- Nurse Practitioner
- Daytona Beach, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN9271273
- Practice address
- 1865 Lpga Blvd
Daytona Beach, FL 32117-7108 - Phone
- (386) 255-4596
- Fax
- (386) 258-3561
- NPI assigned
- Dec 18, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN9271273 | FL | |
| Nurse Practitioner | 363L00000X | APRN9271273 | FL | Primary |
Addresses
Primary practice location
1865 Lpga Blvd
Daytona Beach, FL 32117-7108
Mailing address
1865 Lpga Blvd
Daytona Beach, FL 32117-7108
Phone (386) 255-4596
Other practice location 1
1890 Lpga Blvd Ste 240
Daytona Beach, FL 32117-7131
Phone (386) 255-4596
Other practice location 2
17 Old Kings Rd N Ste K
Palm Coast, FL 32137-8283
Phone (386) 255-4596
Other practice location 3
1165 Dunlawton Ave Ste 102
Port Orange, FL 32127-2924
Phone (386) 255-4596
Other practice location 4
1075 Mason Ave
Daytona Beach, FL 32117-4611
Phone (386) 255-4596
Other practice location 5
1175 Dunlawton Ave Ste 1
Port Orange, FL 32127-4741
Phone (386) 255-4596
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014172900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1865 Lpga Blvd
Daytona Beach, FL 32117-7108
Phone (386) 255-4596
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN9271273 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Clinic of Daytona Beach PA | Current | Accepting new patients | |
| Orthopaedic Clinic of Daytona Beach PA | Current | Accepting new patients |
Locations
1865 Lpga Blvd
Daytona Beach, FL 32117
Phone (386) 255-4596
1890 Lpga Blvd
Ste 240
Daytona Beach, FL 32117
Phone (386) 255-4596
1075 Mason Ave
Daytona Beach, FL 32117
Phone (386) 255-4596
17 Old Kings Rd N
Ste K
Palm Coast, FL 32137
Phone (386) 255-4596
1165 Dunlawton Ave
Ste 102
Port Orange, FL 32127
Phone (386) 255-4596
1175 Dunlawton Ave
Ste 1
Port Orange, FL 32127
Phone (386) 255-4596
Interoperability endpoints
- elton.miranda.1@10735.direct.athenahealth.com
- https://api.platform.athenahealth.com/10735/brand/1/csg/1/fhir/r4
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Daytona Beach, FL
- NPI 1558340240
-
- Durable Medical Equipment & Medical Supplies
- Port Orange, FL
- NPI 1023678745
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Daytona Beach, FL
- NPI 1811991227
-
- General Acute Care Hospital
- Daytona Beach, FL
- NPI 1063426823
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732060800000",
"number": "1225436587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1865 LPGA BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321177108",
"telephone_number": "386-255-4596",
"fax_number": "386-258-3561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1865 LPGA BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321177108",
"telephone_number": "386-255-4596",
"fax_number": "386-258-3561"
}
],
"practiceLocations": [
{
"address_1": "1890 Lpga Blvd Ste 240",
"address_purpose": "LOCATION",
"city": "Daytona Beach",
"state": "FL",
"postal_code": "321177131",
"country_code": "US",
"telephone_number": "386-255-4596",
"fax_number": "386-258-3561",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "17 Old Kings Rd N Ste K",
"address_purpose": "LOCATION",
"city": "Palm Coast",
"state": "FL",
"postal_code": "321378283",
"country_code": "US",
"telephone_number": "386-255-4596",
"fax_number": "386-258-3561",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1165 Dunlawton Ave Ste 102",
"address_purpose": "LOCATION",
"city": "Port Orange",
"state": "FL",
"postal_code": "321272924",
"country_code": "US",
"telephone_number": "386-255-4596",
"fax_number": "386-258-3561",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1075 Mason Ave",
"address_purpose": "LOCATION",
"city": "Daytona Beach",
"state": "FL",
"postal_code": "321174611",
"country_code": "US",
"telephone_number": "386-255-4596",
"fax_number": "386-258-3561",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1175 Dunlawton Ave Ste 1",
"address_purpose": "LOCATION",
"city": "Port Orange",
"state": "FL",
"postal_code": "321274741",
"country_code": "US",
"telephone_number": "386-255-4596",
"fax_number": "386-258-3561",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIRANDA",
"first_name": "ELTON",
"middle_name": "GENE",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-18",
"last_updated": "2024-11-20",
"certification_date": "2024-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN9271273",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "APRN9271273",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "014172900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.