MEDICARE: DR. SHARON MILLER PH.D.

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	SW-0001311	FL

General Provider Information

NPI Number	:	1396998969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON MILLER PH.D.

Provider Business Mailing Address
First Line	:	550 N. REO ST.
Second Line	:	SUITE 300
City	:	TAMPA
State	:	FL
Zip	:	33609-1065
Country	:	US
Telephone Number	:	813-261-5069
Fax Number	:	813-261-5194

Provider Business Practice Location Address
First Line	:	550 N. REO ST.
Second Line	:	SUITE 300
City	:	TAMPA
State	:	FL
Zip	:	33609-1065
Country	:	US
Telephone Number	:	813-261-5069
Fax Number	:

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

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	10/28/2008

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