Healthcare Provider Details

I. General information

NPI: 1851340103
Provider Name (Legal Business Name): DAVID AUGUSTUS MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 JOHN F KENNEDY DR STE B
ATLANTIS FL
33462-1153
US

IV. Provider business mailing address

7593 W BOYNTON BEACH BLVD STE 220
BOYNTON BEACH FL
33437-6162
US

V. Phone/Fax

Practice location:
  • Phone: 561-295-6962
  • Fax: 561-249-2512
Mailing address:
  • Phone: 561-649-7000
  • Fax: 561-964-4603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME48584
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME48584
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: