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Individual
MR. JOSE ANGEL MIRANDA BARRETO
Active
Individual
MR. JOSE ANGEL MIRANDA BARRETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S62758135
DRIVERS LICENSE NUMBER
PR
Enumeration date
07/11/2018
Last updated
07/11/2018
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