Individual
DR. JIOVANI MIRANDA VISAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10150 HAGEN RANCH ROAD, SUITE 100, BOYNTON BEACH, FL 33437
(561) 736-8141
(561) 736-5662
Mailing address
15280 NW 79TH CT STE 100, MIAMI LAKES, FL 33016-5873
(055) 583-7243
(786) 907-4485
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
258899
NY
207Y00000X
Otolaryngology Physician
D77377
MD
207YP0228X
Pediatric Otolaryngology Physician
Primary
ME123156
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015151100
—
FL
Enumeration date
04/20/2009
Last updated
05/24/2023
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