Individual
ELTON GENE MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 258-3561
Mailing address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 258-3561
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN9271273
FL
363LF0000X
Family Nurse Practitioner
APRN9271273
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014172900
—
FL
Enumeration date
12/18/2014
Last updated
11/20/2024
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