Provider Demographics
NPI:1528124534
Name:MIRANDO, JOSEPH MICHAEL (MSPT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:MIRANDO
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:13625 SW 73RD CT
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33158-1209
Mailing Address - Country:US
Mailing Address - Phone:305-271-1309
Mailing Address - Fax:305-644-3328
Practice Address - Street 1:1501 N.W. 4 STREET
Practice Address - Street 2:3RD FLOOR PROMONADE
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-689-1700
Practice Address - Fax:305-644-3328
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20125225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist