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General NPI Number Information
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NPI Number | 1427233006
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Entity Type | Individual
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Provider Name | GLENN PATTERSON MILLER JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 02/09/2022
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Provider Practice Location Address
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Address Line | 7661 NW 107TH AVE APT 612
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City | DORAL
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State | FL
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Zip | 33178-4626
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Country | US
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Telephone | 754-779-4701
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 NW 12TH AVE
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City | MIAMI
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State | FL
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Zip | 33136-1003
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Country | US
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Telephone | 305-585-1178
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Fax | 305-326-7065
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 225758
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME116675
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License Number State | FL
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