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General NPI Number Information
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NPI Number | 1467526343
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Entity Type | Individual
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Provider Name | CLORIDE MILLER M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3229 BEAR RUN BLVD BLDG A
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City | ORANGE PARK
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State | FL
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Zip | 32065-7334
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Country | US
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Telephone | 904-269-6340
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Fax | 904-269-6373
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Provider Business Mailing Address
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Address Line | PO BOX 578
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City | GREEN COVE SPRINGS
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State | FL
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Zip | 32043-0578
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Country | US
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Telephone | 904-269-6340
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Fax | 904-284-6373
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME49092
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License Number State | FL
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