# KCM SERVICE, PSC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Carlos J. Miranda
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376065037
- **Authorized official:** DR. CARLOS J. MIRANDA MD (PRESIDENT)
- **Authorized official phone:** (787) 787-9315

## Contact information

- **Practice address:** BAYAMON PLAZA, SUITE 503, BAYAMON, PR 00959-0095
- **Practice address phone:** (787) 787-9315
- **Practice address fax:** (787) 787-9315
- **Mailing address:** PO BOX 16843, SAN JUAN, PR 00908-6843
- **Mailing address phone:** (787) 787-9315

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/13/2017
- **Last updated:** 07/13/2017