Marietta C Miralles-Bouza, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0057318 Issued in FL

Practice address

690 E 25TH St
Hialeah, FL 33013-3815

Phone

(305) 696-0331

Fax

(305) 696-1239

NPI assigned

Aug 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Bouza & Miralles Medical Associates

  • Specialist
  • Hialeah, FL
  • NPI 1780824573
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1548375033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 E 25TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133815",
            "telephone_number": "305-696-0331",
            "fax_number": "305-696-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 E 25TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133815",
            "telephone_number": "305-696-0331",
            "fax_number": "305-696-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRALLES-BOUZA",
        "first_name": "MARIETTA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0057318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051733000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miracle Blessed Care Enterprises, Inc.
• Miracle Blessed Care Enterprises, Inc.
• Miracle Ear
• Miracle Massage and Rehab Corp
• Miracle Rehab Center, Inc
• Margaret Miralles
• Miramar Pain Medicine, PA
• Miramar Rehabilitation, Inc
• Yeilena Miranda Baullosa
• Katia Miranda Calnick

• Internal Medicine Physician in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.