Healthcare Provider Details

I. General information

NPI: 1801706478
Provider Name (Legal Business Name): MILLER ORTHODONTICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 KINGSWAY RD
BRANDON FL
33510-4637
US

IV. Provider business mailing address

1303 W FLETCHER AVE
TAMPA FL
33612-3310
US

V. Phone/Fax

Practice location:
  • Phone: 813-427-2237
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ZACK MILLER
Title or Position: OWNER/ORTHODONTIST
Credential:
Phone: 813-427-2237