Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | ME0027032 | FL |
NPI | 1053415315 |
---|---|
Provider Name | Mr. Jeffrey Leigh Miller |
First Address | Tampa, FL 33609 |
Second Address | Tampa, FL 33609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2006 |
Last Update Date | 11/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D62113 | (02) |