Jose Antonio Miro Ceballos, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

6979 Issued in PR

Practice address

1003 Calle Acapulco
San Juan, PR 00920-4054

Phone

(787) 749-0849

Fax

(787) 749-9623

NPI assigned

Apr 16, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1720203813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367056",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009367056",
            "telephone_number": "787-749-0849",
            "fax_number": "787-749-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 CALLE ACAPULCO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009204054",
            "telephone_number": "787-749-0849",
            "fax_number": "787-749-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRO CEBALLOS",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "6979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS PROVIDER NUMBER",
            "identifier": "29600MI",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Miranda
• Omar Alexis Miranda, LND
• Rene Osmin Miranda
• Stephany M Ortiz Miranda Sr., PSYD
• Yamilex Miranda, MA
• Angel J Miro-Diaz, MD
• Jose Francisco Miro, MD, FAAPMR
• Mirta Ortiz Ortega Cpa D/B/a Electronic Billing and Consulting Service
• Mises Abreu Cordero
• Mision de Vida - Life Mission Corp

• General Practice Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.