MEDICARE: JOAN MILLER P.T.

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	2251S0007X	Sports Physical Therapist	PTFL4075	FL
2	2251X0800X	Orthopedic Physical Therapist	PTFL4075	FL

General Provider Information

NPI Number	:	1568670644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN MILLER P.T.

Provider Business Mailing Address
First Line	:	PO BOX 7504
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33807-7504
Country	:	US
Telephone Number	:	863-644-7330
Fax Number	:	863-619-8764

Provider Business Practice Location Address
First Line	:	3020 S FLORIDA AVE
Second Line	:	ABBEY BUSINESS PARK, STE 321-B
City	:	LAKELAND
State	:	FL
Zip	:	33803-4053
Country	:	US
Telephone Number	:	863-644-7330
Fax Number	:

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

Provider Enumeration Date	:	05/20/2007
Last Update Date	:	09/11/2025

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