Individual
MRS. AZALIA MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2990 US HIGHWAY 301 N, ELLENTON, FL 34222-2008
(941) 721-1854
(941) 721-1859
Mailing address
PO BOX 15310, SARASOTA, FL 34277-1310
(941) 749-1734
(941) 749-1736
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT22305
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
883054100
—
FL
Enumeration date
05/17/2006
Last updated
01/18/2023
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