Healthcare Provider Details

I. General information

NPI: 1144632449
Provider Name (Legal Business Name): SARAH CHAPPLE MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2014
Last Update Date: 08/29/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14286 BEACH BLVD
JACKSONVILLE FL
32250-1561
US

IV. Provider business mailing address

14286 BEACH BLVD
JACKSONVILLE FL
32250-1561
US

V. Phone/Fax

Practice location:
  • Phone: 904-345-7510
  • Fax: 904-345-7540
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT28125
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: