Most Relevant Information
Provider Data
| NPI Number: | 1003250630 |
| Provider Name: | OMAR ALEXIS MIRANDA LND |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 1843 |
Most Important Dates
| Enumeration Date: | 04/25/2013 |
| Last Updated: | 06/26/2015 |
Provider Practice Location
STREET 1 B-12
URB. COLINAS VERDES
SAN JUAN
PR
009245311
Practice Location Phone/Fax
| Phone: | 7877523928 |
| Fax: |
Provider Mailing Location
STREET 1 B-12
URB. COLINAS VERDES
SAN JUAN
PR
00924
Provider Mailing Phone/Fax
| Phone: | 7877523928 |
| Fax: |