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Organization

DR. RICARDO MIRANDA, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICARDO MIRANDA (OWNER)
(918) 688-8752
Entity
Organization

Contact information

Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 688-8752
Mailing address
PO BOX 52224, TULSA, OK 74152-0224
(918) 688-8752

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16703
OK

Other

Enumeration date
08/16/2011
Last updated
10/17/2011
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