Idalia Montanez-Miranda, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY60898484 Issued in WA

Practice address

130 Shipyard Way Unit 1107
St Augustine, FL 32084-4239

Phone

(805) 505-7210

NPI assigned

Aug 4, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Idalia Montanez Miranda PLLC

  • Clinical Psychologist
  • St Augustine, FL
  • NPI 1588580716
  NPD (past) Authorized official

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1942589296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 126",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320850126",
            "telephone_number": "805-505-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 SHIPYARD WAY UNIT 1107",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320844239",
            "telephone_number": "805-505-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTANEZ-MIRANDA",
        "first_name": "IDALIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-04",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60898484",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60898484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "PY60898484",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Molina-Baez
• Christy Louise Monaghan, PH.D.
• Clark V Monahan, D.C.
• Monarch Mobile Physical Therapy LLC
• Danielle Lane Montana, L.C.S.W.
• Montgomery and Associates MD
• Daniele J Montgomery, MD
• Matthew Montgomery, PA-C
• Tracy Montoya, RDH
• Raul A Monzon, MD

• Psychologist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; 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.