Healthcare Provider Details

I. General information

NPI: 1134485964
Provider Name (Legal Business Name): LAURA MILLER HAHN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2012
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1571 SAWGRASS CORPORATE PKWY STE 140
SUNRISE FL
33323-2807
US

IV. Provider business mailing address

900 COTTAGE GROVE RD
BLOOMFIELD CT
06002-2920
US

V. Phone/Fax

Practice location:
  • Phone: 800-500-6354
  • Fax: 754-551-5397
Mailing address:
  • Phone: 800-400-5364
  • Fax: 754-551-5397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD79475
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: