Provider Demographics
NPI:1548458698
Name:MIRANDA, JOSILANE MOURA (MD)
Entity type:Individual
Prefix:MS
First Name:JOSILANE
Middle Name:MOURA
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANENTE MEDICARE ENROLLMENT
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:
Practice Address - Street 1:1447 YORK RD
Practice Address - Street 2:KAISER PERMANETE TOWSON MEDICAL CENTER
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6038
Practice Address - Country:US
Practice Address - Phone:410-339-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2021-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD00713892084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program