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NPI 1043211964

NPI 1043211964 : ANN MARIE MILLAR DPM : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1043211964
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    Entity Type          |    Individual 
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    Provider Name        |    ANN MARIE MILLAR DPM
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/02/2005
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    Last Update Date     |    08/13/2013
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Provider Practice Location Address
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    Address Line         |    1609 NW 14TH AVENUE 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33125
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    Country              |    US
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    Telephone            |    305-710-0725
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    Fax                  |    786-363-8820
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Provider Business Mailing Address
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    Address Line         |    1609 NW 14TH AVENUE 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33125
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    Country              |    US
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    Telephone            |    305-710-0725
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    Fax                  |    786-363-8820
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    213E00000X
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    Taxonomy Name        |    Podiatrist
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    License Number       |    PO2402
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    License Number State |    FL
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Taxonomy #2
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    Taxonomy Code        |    213E00000X
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    Taxonomy Name        |    Podiatrist
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    License Number       |    P02402
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    License Number State |    FL
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