1316181761 NPI number — MRS. FLORIKA EVELYN MIRANDA R.N.

Table of content: MRS. FLORIKA EVELYN MIRANDA R.N. (NPI 1316181761)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316181761 NPI number — MRS. FLORIKA EVELYN MIRANDA R.N.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MIRANDA
Provider First Name:
FLORIKA
Provider Middle Name:
EVELYN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
R.N.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VALOIS
Provider Other First Name:
FLORIKA
Provider Other Middle Name:
EVELYN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN,GCM
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1316181761
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1325 MCKINLEY PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LACKAWANNA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14218-1641
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-823-1476
Provider Business Mailing Address Fax Number:
716-299-2800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1325 MCKINLEY PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LACKAWANNA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14218-1641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-823-1476
Provider Business Practice Location Address Fax Number:
716-299-2800
Provider Enumeration Date:
04/29/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WC0400X , with the licence number:  372780-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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