Individual provider Active NPI

Sharlene Monique Miranda, O.D.

  • Optometrist
  • Guaynabo, PR
National Provider Identifier
1609961291
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
630 Issued in PR
Practice address
Infinity Laser Center
City View Plaza Lobby Suite 117
Guaynabo, PR 00968
Phone
(787) 775-2020
NPI assigned
Oct 3, 2006
Last updated
Feb 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 630 PR Primary

Addresses

Primary practice location

Infinity Laser Center
City View Plaza Lobby Suite 117
Guaynabo, PR 00968

Mailing address

Urb. la Alhambra
2519 Obispado Ave.
Ponce, PR 00716-3840
Phone (787) 396-0177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080520000129 PR Practitioner - Optometry 5294804043 Practice locations: Salinas, PR; Ponce, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
630PRMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Miranda Visual Clinic & Optical LLC Optometrist Current Accepting new patients
Optica Ruben Nieves Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1609961291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. LA ALHAMBRA",
            "address_2": "2519 OBISPADO AVE.",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007163840",
            "telephone_number": "787-396-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "INFINITY LASER CENTER",
            "address_2": "CITY VIEW PLAZA LOBBY SUITE 117",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00968",
            "telephone_number": "787-775-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "SHARLENE",
        "middle_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

Verify at the official NPI Registry.