Active NPI
Fabiola Miranda
- Internal Medicine Physician
- St Petersburg, FL
National Provider Identifier
1275112609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME177470
- Practice address
- 1839 Central Ave
St Petersburg, FL 33713-9089 - Phone
- (727) 322-1054
- Fax
- (727) 322-2725
- NPI assigned
- Apr 4, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NM | ||
| Internal Medicine Physician | 207R00000X | ME177470 | FL | Primary |
Addresses
Primary practice location
1839 Central Ave
St Petersburg, FL 33713-9089
Mailing address
1839 Central Ave
St Petersburg, FL 33713-9089
Phone (727) 322-1054
Other practice location 1
Msc10 5580 1 University Of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-2321
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1839 Central Ave
St Petersburg, FL 33713-9089
Phone (727) 322-1054
Hospital & facility affiliations
- Oak Manor Healthcare & Rehabilitation Center
- Palm Garden of Largo
- Westminster Suncoast
- Freedom Square Health Care Center
- Springs at Boca Ciega Bay
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME177470 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Health Care of Pinellas LLC | Internal Medicine | Current | Accepting new patients |
| Professional Health Care of Pinellas Inc. | Current | Accepting new patients |
Locations
1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EIJHAA
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- St Petersburg, FL
- NPI 1881647253
-
- Vascular Surgery Physician
- Hallandale Beach, FL
- NPI 1396147138
-
- Chiropractor
- St Petersburg, FL
- NPI 1568970903
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Skilled Nursing Facility
- St Petersburg, FL
- NPI 1467488981
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764720000000",
"number": "1275112609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1839 CENTRAL AVE",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337139089",
"telephone_number": "727-322-1054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1839 CENTRAL AVE",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337139089",
"telephone_number": "727-322-1054",
"fax_number": "727-322-2725"
}
],
"practiceLocations": [
{
"address_1": "Msc10 5580 1 University Of New Mexico",
"address_purpose": "LOCATION",
"city": "Albuquerque",
"state": "NM",
"postal_code": "871310001",
"country_code": "US",
"telephone_number": "505-272-2321",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIRANDA",
"first_name": "FABIOLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-04",
"last_updated": "2025-12-03",
"certification_date": "2025-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NM",
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME177470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; 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.