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Organization

DE LA CRUZ MIRANDA ORTHOPEDIC SERVICES PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANTONIO ALBERTO MIRANDA M.D. (PRESIDENT)
(787) 798-7050
Entity
Organization

Contact information

Practice address
B1 CALLE SANTA CRUZ, SUITE 403 CARIMED PLAZA, BAYAMON, PR 00961
(787) 798-7050
(787) 787-2107
Mailing address
B17 CALLE POPPY, PARQUE FORESTAL, SAN JUAN, PR 00926
(787) 798-7050
(787) 787-2107

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
12964
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
81409
TRIPLE S
PR
Enumeration date
02/26/2014
Last updated
02/26/2014
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