Healthcare Provider Details

I. General information

NPI: 1376547190
Provider Name (Legal Business Name): MAUREEN ELIZABETH MILLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 08/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 SE 7TH ST SUITE C
BOCA RATON FL
33432-6134
US

IV. Provider business mailing address

30 SE 7TH ST SUITE C
BOCA RATON FL
33432-6134
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-0109
  • Fax: 305-595-2836
Mailing address:
  • Phone: 305-595-0109
  • Fax: 305-595-2836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME0070919
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: