1033533567 NPI number — ALEJANDRA MIRANDA DDS PA

Table of content: MRS. SHARON FAYE SCHMITT COSMETOLOGIST (NPI 1386726776)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033533567 NPI number — ALEJANDRA MIRANDA DDS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALEJANDRA MIRANDA DDS PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033533567
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5232 W FLAGLER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORAL GABLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33134-1168
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5232 W FLAGLER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORAL GABLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33134-1168
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-442-0331
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/04/2014

Additional Information

Authorized Official

Authorized Official Last Name:
MIRANDA
Authorized Official First Name:
ALEJANDRA
Authorized Official Middle Name:
Authorized Official Title or Position:
DENTIST
Authorized Official Telephone Number:
305-442-0331

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DN13131 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 073988001 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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