Healthcare Provider Details

I. General information

NPI: 1497571475
Provider Name (Legal Business Name): JEWEL MIILER HCP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 LITHIA PINECREST RD
VALRICO FL
33596-6302
US

IV. Provider business mailing address

7126 COLUMNS CIR APT 303
NEW PORT RICHEY FL
34655-3653
US

V. Phone/Fax

Practice location:
  • Phone: 813-655-3300
  • Fax:
Mailing address:
  • Phone: 727-242-0294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: