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Individual

MR. CARLOS GUILLERMO MIRANDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
904B CYPRESS PKWY, KISSIMMEE, FL 34759-3456
(407) 483-1400
(407) 483-1405
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(305) 500-2000

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA08679200
NJ
207R00000X
Internal Medicine Physician
Primary
ME147423
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002521000
FL
01
12076391
CAQH
Enumeration date
10/29/2009
Last updated
02/13/2026
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