Healthcare Provider Details

I. General information

NPI: 1730702390
Provider Name (Legal Business Name): JAMES ROBERT MILLER MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2020
Last Update Date: 05/18/2020
Certification Date: 05/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5331 COMMERCIAL WAY STE 203
SPRING HILL FL
34606-1426
US

IV. Provider business mailing address

5331 COMMERCIAL WAY
SPRING HILL FL
34606-1449
US

V. Phone/Fax

Practice location:
  • Phone: 352-573-8000
  • Fax: 352-364-0116
Mailing address:
  • Phone: 352-573-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH17399
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17399
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number17399
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: