Individual
MARK MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
300 E HOSPITAL RD, FORT GORDON, GA 30905
(706) 787-5811
Mailing address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-4499
(210) 916-0005
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1074050
TX
Other
Enumeration date
02/21/2020
Last updated
07/21/2025
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