Provider Demographics
NPI:1235923970
Name:MIRABEL, SIRRI
Entity type:Individual
Prefix:
First Name:SIRRI
Middle Name:
Last Name:MIRABEL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2541 STEEPLECHASE DR APT 1B
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-5505
Mailing Address - Country:US
Mailing Address - Phone:937-540-5064
Mailing Address - Fax:
Practice Address - Street 1:2541 STEEPLECHASE DR APT 1B
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-5505
Practice Address - Country:US
Practice Address - Phone:937-540-5064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSV688536347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle