Andrea Miranda, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT28686 Issued in FL

Practice address

1885 S 14TH St
Fernandina Beach, FL 32034-3033

Phone

(904) 277-4449

NPI assigned

Dec 6, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Paola A Ortiz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1639613946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1885 S 14TH ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343033",
            "telephone_number": "904-277-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 S 14TH ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343033",
            "telephone_number": "904-277-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "ANDREA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-06",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAOLA",
            "last_name": "ORTIZ",
            "middle_name": "A",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda L Miller-Hodges, LMHC, C-DBT
• Alan Edward Miller, M.D.
• Carly J Miller, M.D.
• Jacquelyn Olbina Miller, D.M.D.
• Colin Milo
• Nicole Marie Mischler, ARNP
• Barbara Moger, CRNA
• Laura Frances Momnie, SLP
• John Hartwell Houston Mooney, M.D.
• Colin Moore

• All providers in Fernandina Beach, FL
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.