Healthcare Provider Details

I. General information

NPI: 1154397297
Provider Name (Legal Business Name): MONICA MILLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2318 GREENBRANCH DR BLDG 2, STE 101
WESLEY CHAPEL FL
33544-6797
US

IV. Provider business mailing address

2318 GREENBRANCH DR BLDG 2, STE 101
WESLEY CHAPEL FL
33544-6797
US

V. Phone/Fax

Practice location:
  • Phone: 813-866-4626
  • Fax: 813-972-8866
Mailing address:
  • Phone: 813-866-4626
  • Fax: 813-972-8866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number224871
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberME130020
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME130020
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: