Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 11006113 | FL |
NPI | 1366076267 |
---|---|
Provider Name | Stephanie Helen Miller |
First Address | Orlando, FL 32891-0001 |
Second Address | Tampa, FL 33606-3571 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2020 |
Last Update Date | 31/03/2021 |