Provider Demographics
NPI:1528663846
Name:MIRANDA, EMANUELLA BORBA (APRN)
Entity type:Individual
Prefix:
First Name:EMANUELLA
Middle Name:BORBA
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:401 OCEAN DR APT 808
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-6632
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:825 ARTHUR GODFREY RD STE 200
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3304
Practice Address - Country:US
Practice Address - Phone:305-763-8080
Practice Address - Fax:305-763-8064
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11010436363LF0000X
FLAPRN11010436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily