Organization
DE LA CRUZ MIRANDA ORTHOPEDIC SERVICES PSC
Active
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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