Individual
MR. CARLOS CESAR MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 742-4133
(617) 643-7941
Mailing address
200 NE 26TH DR, WILTON MANORS, FL 33334-2012
(954) 990-3199
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11015373
FL
363L00000X
Nurse Practitioner
RN2373500
MA
363LG0600X
Gerontology Nurse Practitioner
APRN11015373
FL
Other
Enumeration date
09/22/2021
Last updated
12/28/2022
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