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Individual

ALEJANDRO J MIRANDA-SOUSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4571 COLONIAL BLVD STE 110, FORT MYERS, FL 33966-1156
(239) 226-2727
(239) 939-9876
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
(392) 599-2612

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
227880
MA
208800000X
Urology Physician
Primary
ME111307
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14JS5
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
01
355413
AVMED
FL
01
362828
UNIVERSAL HEALTHCARE
FL
01
6442922
CIGNA
FL
01
9238059
AETNA
FL
01
P01052889
RAILROAD MEDICARE
FL
01
P1000190
FREEDOM HEALTH
FL
01
P941227
FREEDOM HEALTH - OPTIMUM
FL
Enumeration date
08/18/2006
Last updated
03/09/2021
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