Organization
MIRACLE MEDICAL CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRISAIDA DUARTE (CEO)
(786) 315-6818
Entity
Organization
Contact information
Practice address
15668 SW 72ND ST, MIAMI, FL 33193-1923
(786) 697-1150
Mailing address
15668 SW 72ND ST, MIAMI, FL 33193-1923
(786) 697-1150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13077
AHCA
FL
Enumeration date
05/09/2022
Last updated
04/30/2025
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