Healthcare Provider Details

I. General information

NPI: 1518233451
Provider Name (Legal Business Name): H. BARRY MILLER, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 03/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3363 SHERIDAN STREET SUITE #210
HOLLYWOOD FL
33021-3658
US

IV. Provider business mailing address

3363 SHERIDAN STREET SUITE #210
HOLLYWOOD FL
33021-3658
US

V. Phone/Fax

Practice location:
  • Phone: 954-987-4100
  • Fax: 954-987-4577
Mailing address:
  • Phone: 954-987-4100
  • Fax: 954-987-4577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberME37969
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME37969
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME37969
License Number StateFL

VIII. Authorized Official

Name: DR. HOWARD BARRY MILLER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 954-987-4100