Healthcare Provider Details

I. General information

NPI: 1336598473
Provider Name (Legal Business Name): DANIEL MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 11/22/2022
Certification Date: 11/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

392 RINEHART RD STE 3000
LAKE MARY FL
32746-2548
US

IV. Provider business mailing address

1222 S ORANGE AVE FL 5
ORLANDO FL
32806-1215
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-5851
  • Fax: 321-842-2495
Mailing address:
  • Phone: 321-841-1764
  • Fax: 321-841-1870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberTRN23506
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME155921
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: