MEDICARE: MRS. KRISTIN MARY MILLER PT

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	225100000X	Physical Therapist	5195	FL

General Provider Information

NPI Number	:	1679896146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIN MARY MILLER PT

Provider Business Mailing Address
First Line	:	2950 CLEVELAND CLINIC BLVD
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-3609
Country	:	US
Telephone Number	:	954-659-5370
Fax Number	:	954-659-5371

Provider Business Practice Location Address
First Line	:	2959 CLEVELAND CLINC BLVD
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331
Country	:	US
Telephone Number	:	954-659-5370
Fax Number	:	954-659-5371

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

Provider Enumeration Date	:	03/11/2010
Last Update Date	:	03/11/2010

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