| Doctor Name: | MR. OMAR ALEXIS MIRANDA |
| NPI Number: | 1003250630 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LND |
| License Number: | 1843 |
| Business Practice Address: | Street 1 B-12 Urb. Colinas Verdes San Juan, PR - 009245311 |
| Business Phone Number: | 7877523928 |
| Business Fax Number: | |
| Mailing Address: | Street 1 B-12, Urb. Colinas Verdes SAN JUAN |
| State: | PR |
| Postal Code: | 00924 |
| Phone Number: | 7877523928 |
| Fax Number: | |
| NPI Enumeration Date: | 04/25/2013 |
| NPI Last Update Date: | 06/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 1843 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |