Healthcare Provider Details

I. General information

NPI: 1023214970
Provider Name (Legal Business Name): MARTINE JULES MILLER LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARTINE JULES MILLER LPN

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 SW 101ST AVE STE 206
MIRAMAR FL
33025-5090
US

IV. Provider business mailing address

2101 SW 101ST AVE STE 206
MIRAMAR FL
33025-5090
US

V. Phone/Fax

Practice location:
  • Phone: 754-244-5808
  • Fax: 305-676-9040
Mailing address:
  • Phone: 754-368-4921
  • Fax: 305-676-9040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN941521
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number235378
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: