MEDICARE: MILLER CHIROPRACTIC & MEDICAL CENTERS, INC.

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	261Q00000X	Clinic/Center	HCC 4586	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HCC 4586	OTHER	FL	AHCA LICENSE

General Provider Information

NPI Number	:	1467588202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLER CHIROPRACTIC & MEDICAL CENTERS, INC.

Provider Business Mailing Address
First Line	:	720 E FLETCHER AVE
Second Line	:	SUITE 110
City	:	TAMPA
State	:	FL
Zip	:	33612-2616
Country	:	US
Telephone Number	:	813-903-2383
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 S US HIGHWAY 301
Second Line	:	SUITE B
City	:	TAMPA
State	:	FL
Zip	:	33619-4903
Country	:	US
Telephone Number	:	813-664-6934
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MRS. SHERRY A MILLER
Credential	:
Telephone Number	:	813-376-2841

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	08/22/2020

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