Individual provider · NPI-1
Maily Betancourt Miranda, SA-C
Specialist/Technologist, Other, Surgical Assistant · Hialeah, FL
NPI number1760336994
StatusActive
Last updated in NPPESSep 25, 2026
Details
- NPI
- 1760336994
- Entity type
- Individual (NPI-1)
- Name
- Maily Betancourt Miranda
- Credential
- SA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 24, 2026
- Certification date
- Sep 25, 2026
- Last updated
- Sep 25, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | 26-141 | FL | Yes |
| 363AM0700X | Physician Assistant, Medical | 3213 | PR |
Practice location
1250 W 30th St Apt 9Hialeah, FL 33012-4847
Phone 305-778-8922
Mailing address
1250 W 30th St Apt 9Hialeah, FL 33012-4847
Phone 305-778-8922
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