Individual
GRISLEM MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23921 SW 106TH PL, HOMESTEAD, FL 33032-6152
(786) 342-3809
Mailing address
23921 SW 106TH PL, HOMESTEAD, FL 33032-6152
(786) 342-3809
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
11036748
FL
Other
Enumeration date
12/12/2024
Last updated
12/12/2024
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