Individual provider Active NPI

Ada Smyrna Miranda, M.D.

  • Pediatric Hospice and Palliative Medicine Physician
  • Arecibo, PR
National Provider Identifier
1689886525
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hospice and Palliative Medicine PhysicianTaxonomy code 2080H0002X
License
5412 Issued in PR
Practice address
Hospital Metropolitano Dr. Susoni
Calle Palma
Arecibo, PR 00613
Phone
(787) 650-1030
Fax
(787) 650-1040
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hospice and Palliative Medicine Physician 2080H0002X 5412 PR Primary

Addresses

Primary practice location

Hospital Metropolitano Dr. Susoni
Calle Palma
Arecibo, PR 00613

Mailing address

Villas del Capitan Solandra Aa 18 Buzon 38
Arecibo, PR 00612
Phone (787) 879-0732

Other identifiers 1

IdentifierTypeStateIssuer
5412OtherPRSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5412PRMDPediatric Hospice and Palliative Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689886525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VILLAS DEL CAPITAN SOLANDRA AA 18 BUZON 38",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-879-0732",
            "fax_number": "787-879-0732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL METROPOLITANO DR. SUSONI",
            "address_2": "CALLE PALMA",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00613",
            "telephone_number": "787-650-1030",
            "fax_number": "787-650-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "ADA",
        "middle_name": "SMYRNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "PR",
            "license": "5412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5412",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.