MEDICARE: DR. JEFFREY MILEY PHARM.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	183500000X	Pharmacist	PS40785	FL
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PS40785	FL

General Provider Information

NPI Number	:	1578808580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY MILEY PHARM.D.

Provider Business Mailing Address
First Line	:	5910 CANDYTUFT PL
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-2669
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5910 CANDYTUFT PL
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-2669
Country	:	US
Telephone Number	:	813-210-6124
Fax Number	:

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

Provider Enumeration Date	:	12/02/2012
Last Update Date	:	12/02/2012

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