Healthcare Provider Details

I. General information

NPI: 1265450159
Provider Name (Legal Business Name): STEPHEN J MILLER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6280 SUNSET DR SUITE 505
SOUTH MIAMI FL
33143-4870
US

IV. Provider business mailing address

6280 SUNSET DR SUITE 505
SOUTH MIAMI FL
33143-4870
US

V. Phone/Fax

Practice location:
  • Phone: 305-668-5636
  • Fax: 305-668-5621
Mailing address:
  • Phone: 305-668-5636
  • Fax: 305-668-5621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberME0067852
License Number StateFL

VIII. Authorized Official

Name: DR. STEPHEN JAY MILLER
Title or Position: PRESIDENT
Credential: MD
Phone: 305-668-5636