Provider Demographics
NPI:1427301126
Name:MIRANDA, AMPARO AUXILIADORA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMPARO
Middle Name:AUXILIADORA
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-5345
Mailing Address - Country:US
Mailing Address - Phone:407-886-8911
Mailing Address - Fax:407-886-0357
Practice Address - Street 1:125 E MAIN ST
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-5345
Practice Address - Country:US
Practice Address - Phone:407-886-8911
Practice Address - Fax:407-886-0357
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49452183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist