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Individual

MR. JOHNNY MIRACOLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
255 N UNIVERSITY DR, PEMBROKE PINES, FL 33024-6715
(954) 987-2421
(954) 987-1398
Mailing address
255 N UNIVERSITY DR, PEMBROKE PINES, FL 33024-6715
(954) 987-2421
(954) 987-1398

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO6492
FL

Other

Enumeration date
03/28/2023
Last updated
03/28/2023
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