Healthcare Provider Details

I. General information

NPI: 1053461053
Provider Name (Legal Business Name): FLOYD I MILLER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2175 N ALMA SCHOOL RD STE C109
CHANDLER AZ
85224-2880
US

IV. Provider business mailing address

2034 E SOUTHERN AVE STE W
TEMPE AZ
85282-7519
US

V. Phone/Fax

Practice location:
  • Phone: 480-545-2610
  • Fax: 480-545-2673
Mailing address:
  • Phone: 480-219-3766
  • Fax: 480-219-3768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0548
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: