MEDICARE: DR. KATHRYN ELAINE MILLER DO, MBA

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	207W00000X	Ophthalmology Physician	UO3322	FL
2	207W00000X	Ophthalmology Physician	OS13933	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346581634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHRYN ELAINE MILLER DO, MBA

Provider Business Mailing Address
First Line	:	11195 S JOG RD STE 1&2
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-1829
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11195 S JOG RD STE 1&2
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-1829
Country	:	US
Telephone Number	:	561-752-0075
Fax Number	:

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

Provider Enumeration Date	:	03/12/2013
Last Update Date	:	05/25/2021

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