Healthcare Provider Details

I. General information

NPI: 1245271337
Provider Name (Legal Business Name): HOLLY RAASS MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 05/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 MEDICAL BLVD SUITE 300
NAPLES FL
34110-1413
US

IV. Provider business mailing address

1660 MEDICAL BLVD SUITE 300
NAPLES FL
34110-1413
US

V. Phone/Fax

Practice location:
  • Phone: 239-513-0053
  • Fax: 239-596-0900
Mailing address:
  • Phone: 239-513-0053
  • Fax: 239-596-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD40957
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME104443
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: