Individual
MR. ISMAEL MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1611 NW 12TH AVE # R-143, MIAMI, FL 33136-1005
(305) 585-7224
Mailing address
450 NE 115TH ST, MIAMI, FL 33161-6660
(305) 891-6297
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1492
FL
Other
Enumeration date
08/15/2006
Last updated
07/08/2007
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