Individual
JEREMIAH JOSEPH JUANCO-MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20203 REGAL FERN CT, TAMPA, FL 33647-3651
(813) 607-7768
Mailing address
20203 REGAL FERN CT, TAMPA, FL 33647-3651
(813) 607-7768
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
30860
FL
Other
Enumeration date
04/03/2021
Last updated
04/03/2021
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