Organization
MAYRA M MIRO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYRA M MIRO PSYD (OWNER)
(305) 807-9119
Entity
Organization
Contact information
Practice address
11401 SW 40TH ST, MIAMI, FL 33165-3372
(305) 807-9119
(305) 445-9045
Mailing address
11401 SW 40TH ST, MIAMI, FL 33165-3372
(305) 807-9119
(305) 445-9045
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY7369
FL
Other
Enumeration date
11/07/2012
Last updated
11/07/2012
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