MEDICARE: DAVID MILLER RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS23214	FL

General Provider Information

NPI Number	:	1043856016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MILLER RPH

Provider Business Mailing Address
First Line	:	2000 STATE ROAD 60 E
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33898-5182
Country	:	US
Telephone Number	:	863-676-9468
Fax Number	:	863-678-3715

Provider Business Practice Location Address
First Line	:	2000 STATE ROAD 60 E
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33898-5182
Country	:	US
Telephone Number	:	863-676-9468
Fax Number	:	863-678-3715

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2019
Last Update Date	:	11/25/2019

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Directions to “ DAVID MILLER RPH” Practice Location

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