Individual
IBELITH MIRANDA-MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1051 KEVSTIN DR, KISSIMMEE, FL 34744-5811
(321) 257-8007
(407) 490-1309
Mailing address
PO BOX 4189, DEERFIELD BEACH, FL 33442-4189
(954) 363-9582
(954) 363-9663
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ACN1390
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112495900
—
FL
Enumeration date
07/24/2006
Last updated
07/24/2025
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