Individual
JEIDIMAR COLON MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4020 EASTERN AVE, BALTIMORE, MD 21224-4225
(410) 534-8656
Mailing address
119 LUCCA LN APT 221, ABINGDON, MD 21009-1480
(787) 319-1088
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
27533
MD
Other
Enumeration date
09/04/2020
Last updated
09/04/2020
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