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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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MIRANDA, RICARDO       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 11202 HARVARD AVE
TULSA OK 74137

Address last updated on 10/20/2023
Phone #: (918) 688-8752
Fax #:
County: TULSA
License: 16703
Dated: 11/4/1988
Expires: 11/1/2025
Training Issued: 6/29/1988
Training Expires: 12/31/1988
License Type: Medical Doctor
Specialty: Neonatal-Perinatal Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Auto De Ciudad Juarez, Esc De Med, Ciudad Juarez, Chihuahua
Graduated: 6 / 1979
CME Year: 2027
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF PEDIATRICS
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: Aetna HMO
Aetna PPO
BlueChoice PPO
BlueLincs HMO
CIGNA HMO
CIGNA PPO
CommunityCare HMO, Inc
HealthChoice
Heartland Health Plan of Oklahoma
PacifiCare of Oklahoma, Inc
Preferred Community Choice
Prime Advantage Health Plan
Prudential Health Care Plan, Inc
UniCare Health Plans of Oklahoma
United Healthcare HMO
United Healthcare Options PPO
Welcor/Sooner
Hospital Privileges: Ascension St. John - Owasso
Owasso, OK
Ascension St. John Medical Center
Tulsa, OK
Hillcrest Hospital South (fmly SouthCrest)
Tulsa, OK
Muskogee Community Hospital
Muskogee, OK
St. Francis Hospital - Muskogee (frmly Muskogee Reg. Med. Ctr./Eastar)
Muskogee, OK
Locations: Hours: Languages:
11202 HARVARD AVE
TULSA OK 74137

Phone #: (918) 688-8752
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
Spanish
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
AMOS ADESOKAN APRN 17526
KRISTIN COFFMAN APRN 79301
KELLIE SWIM APRN 74972
RHONDA TOOTILL APRN 69798
CATHERINE ELAINE WILLIAMS PA 3081

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