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NPI Code Detail

MEDICARE: MRS. CASSANDRA MILLER

MEDICARE:  MRS. CASSANDRA  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
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General Provider Information

NPI Number : 1235432618
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CASSANDRA MILLER
Provider Business Mailing Address
First Line : 5325 CORDGRASS BEND LN
Second Line :
City : PORT ORANGE
State : FL
Zip : 32128-3000
Country : US
Telephone Number : 386-334-7257
Fax Number :
Provider Business Practice Location Address
First Line : 5325 CORDGRASS BEND LN
Second Line :
City : PORT ORANGE
State : FL
Zip : 32128-3000
Country : US
Telephone Number : 386-334-7257
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2010
Last Update Date : 12/07/2010

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Directions to “ MRS. CASSANDRA MILLER ” Practice Location

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