Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Max Miranda, PA

Individual provider Physician Assistant · NPI 1639044050

Max Miranda, PA is a Physician Assistant in Lakeland, Florida. Qualified in 2025, 1 year ago. Practices with Radiology and Imaging Specialists of Lakeland, a 70-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
1
Licensed in
FL
In the registry since
2025
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1417 Lakeland Hills Blvd Ste 102
Lakeland, FL 33805-3200
Phone: (863) 577-0316
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9121197 (FL)

Record details

NPI number1639044050
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 7, 2025
Last updated in NPPESFebruary 9, 2026
Certification dateFebruary 9, 2026
Mailing address2115 Crystal Grove Dr, Lakeland, FL 33801-6875

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Radiology And Imaging Specialists Of Lakeland — 70 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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