Provider Demographics
NPI:1861426322
Name:MIRANDA LAMA, ESMERALDA (MD)
Entity type:Individual
Prefix:DR
First Name:ESMERALDA
Middle Name:
Last Name:MIRANDA LAMA
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LA TORRE DE PLAZA LAS AMERICAS STE 614
Mailing Address - Street 2:525 AVE FD ROOSEVELT
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-8056
Mailing Address - Country:US
Mailing Address - Phone:787-767-7700
Mailing Address - Fax:787-767-7700
Practice Address - Street 1:TORRE PLAZA LAS AMERICAS STE 614
Practice Address - Street 2:525 AVE FD ROOSEVELT
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-8056
Practice Address - Country:US
Practice Address - Phone:787-767-7700
Practice Address - Fax:787-767-7700
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR0121102081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H44973Medicare UPIN
0020706Medicare ID - Type Unspecified