Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | ME15289 | FL |
NPI | 1013980093 |
---|---|
Provider Name | Mr. Murray Jack Miller |
First Address | Lauderdale Lakes, FL 33313-7266 |
Second Address | Lauderdale Lakes, FL 33313-7266 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 12/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
269633900 | (05) | FL |
D65554 | (02) |