MEDICARE: MS. LEIRMA MILLER

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	1041C0700X	Clinical Social Worker	SW7759	FL

General Provider Information

NPI Number	:	1194121277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LEIRMA MILLER

Provider Business Mailing Address
First Line	:	6350 W COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-7823
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6350 W COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-7823
Country	:	US
Telephone Number	:	407-447-7117
Fax Number	:

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

Provider Enumeration Date	:	11/17/2014
Last Update Date	:	11/17/2014

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