Individual
MR. RONALDO MIRANDA AUSTRIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
300 WINDY HILL DR, LAFAYETTE, IN 47905-2862
(765) 477-7791
(765) 474-2986
Mailing address
300 WINDY HILL DR, LAFAYETTE, IN 47905-2862
(765) 477-7791
(765) 474-2986
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008284A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001010183
ANTHEM PROVIDER NUMBER
IN
05
—
201355960
—
IN
Enumeration date
07/22/2008
Last updated
06/06/2016
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