Healthcare Provider Details

I. General information

NPI: 1467123745
Provider Name (Legal Business Name): SAVANNAH LEIGH MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2021
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8320 W SUNRISE BLVD STE 208
PLANTATION FL
33322-5432
US

IV. Provider business mailing address

1034 GROVE ST
MEADVILLE PA
16335-2945
US

V. Phone/Fax

Practice location:
  • Phone: 800-640-3451
  • Fax:
Mailing address:
  • Phone: 814-373-2923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP024411
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: