DR. WIDALYS SANTIAGO MIRANDA (NPI# 1104063023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104063023 |
Entity Type | Individual |
Full Name | DR. WIDALYS SANTIAGO MIRANDA |
Credential | M.D. |
Practice Address |
140 W Government St Pensacola FL 32502-5703 |
Mailing Address |
Po Box 4274 Milton FL 32572-4274 |
Practice Telephone | 9186163366 |
Mailing Telephone | 9186163366 |
Enumeration Date | 2009-01-14 |
Last Update Date | 2019-05-02 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | ACN885 | FL | Allopathic & Osteopathic Physicians |
N | 208D00000X | General Practice | 17440 | PR | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | ACN MEDICAL LICENSE | ACN885 | 01 |
FL | DEPARTMENT OF JUSTICE DEA | FS1246669 | 01 |
Street Address |
140 W GOVERNMENT ST |
City | PENSACOLA |
State | FL |
Zip Code | 32502-5703 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275199762 | Anita Kay Morris | Marriage & Family Therapist | 25 W Cedar St Ste 205, Pensacola, FL 32502 | 2019-05-10 |
1013409028 | Everydaydoctor Inc | Internal Medicine | 13 Palafox Pl Ste 200, Pensacola, FL 32502 | 2018-06-05 |
1780119115 | Felisha Palmer | Nurse's Aide | 619 W Gregory St Apt A, Pensacola, FL 32502 | 2017-04-24 |
1619428257 | Young Men's Christian Association of Northwest Florida, Inc. | Health Educator | 165 E.intendencia Street, Pensacola, FL 32502 | 2016-10-19 |
1972968386 | Lauren Reeves | Counselor | 435 E Zarragossa St, Pensacola, FL 32502 | 2015-12-30 |
1902202492 | Amabel Arquillano | Physical Therapist | 600 West Gregory Street, Pensacol, FL 32502 | 2014-11-10 |
1639579568 | Community Experiences LLC | Home Health | 321 N Devillers St Suite 221, Pensacola, FL 32502 | 2014-08-28 |
1831523612 | Our Lady of Angels, St. Joseph Medical Clinic, Inc | Clinic/Center | 131 W. Intendencia St., Pensacola, FL 32502 | 2013-08-28 |
1295013266 | Sabrina Gail Evans | Family Medicine | 236 West Garden Street, Pensacola, FL 32502 | 2011-07-25 |
1356538771 | Optum Infusion Services 204, Inc. | Pharmacy | 201 N. Tarragona Street, Pensacola, FL 32502 | 2007-09-30 |
Find all providers in zip 32502 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851939813 | Cher Lakeesha Nix | General Practice | 1820 W De Soto St, Pensacola, FL 32501-6432 | 2019-12-20 |
1386012896 | Anil Kumar Raj | General Practice | 40 S Alcaniz St, Pensacola, FL 32502-6008 | 2015-09-14 |
1609267475 | Stephen C. Lott, Psy.d. LLC | General Practice | 105 E Gregory Sq, Suite G, Pensacola, FL 32502-4971 | 2015-02-13 |
1871831958 | Peter Christian Delevett | General Practice | 131 W Intendencia St, Pensacola, FL 32502-5708 | 2013-01-23 |
1518282417 | Timothy Duane Brooks | General Practice | 4806 Rosemont Pl, Pensacola, FL 32514-7909 | 2010-04-02 |
1699956730 | Tim J Gallagher | General Practice | 382 Gulfview Ln, Pensacola, FL 32507-7840 | 2007-11-16 |
1750437497 | Minh Cong Pham | General Practice | 2812 W Cervantes St, Pensacola, FL 32505-7159 | 2007-01-26 |
1336218023 | Kenric Turingan Aban | General Practice | 2325 Aegean Ter, Pensacola, FL 32503-5854 | 2006-11-07 |
1396838090 | Lieng Kim Du | General Practice | 907 North U Street, Pensacola, FL 32505 | 2006-10-02 |
1679543797 | Nora B Wilcox | General Practice | Nbhc, Bldg #3600, Pensacola, FL 32508-0000 | 2006-01-23 |
Find all providers in PENSACOLA |
Please comment or provide details below to improve the information on DR. WIDALYS SANTIAGO MIRANDA.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.