Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 24086 | FL |
N | 225X00000X | Occupational Therapist | 12648 | FL |
NPI | 1013187095 |
---|---|
Provider Name | Dr. Jeffrey Kenneth Miller |
First Address | Orlando, FL 32828-8340 |
Second Address | Altamonte Springs, FL 32701-7841 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2008 |
Last Update Date | 08/07/2008 |