Provider Demographics
NPI:1023005204
Name:MIRANDA, FRANCISCO (MD)
Entity type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:
Last Name:MIRANDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 SW 107TH AVE STE 200B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2809
Mailing Address - Country:US
Mailing Address - Phone:786-558-4562
Mailing Address - Fax:786-558-4667
Practice Address - Street 1:9900 SW 107TH AVE STE 200B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2809
Practice Address - Country:US
Practice Address - Phone:786-558-4562
Practice Address - Fax:786-558-4667
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME58018207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373286000Medicaid
23368AMedicare ID - Type Unspecified
FL373286000Medicaid