Doctor Name: | YANDY MIRANDA |
NPI Number: | 1366858078 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D |
License Number: | 31017 |
Business Practice Address: | Ave Hostos # 410 Mayaguez, PR - 006826353 |
Business Phone Number: | 7876529200 |
Business Fax Number: | |
Mailing Address: | 130 Calle Coral, Alturas Del Mar CABO ROJO |
State: | PR |
Postal Code: | 006233184 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/02/2014 |
NPI Last Update Date: | 07/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 31017 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |