=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497804470
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DEAN&MILLER,MD'S,PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/09/2007
-----------------------------------------------------
Last Update Date | 01/10/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 415 N CAUSEWAY
-----------------------------------------------------
City | NEW SMYRNA BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32169-5235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 386-427-4143
-----------------------------------------------------
Fax | 386-427-0711
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 415 N CAUSEWAY
-----------------------------------------------------
City | NEW SMYRNA BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32169-5235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 386-427-4143
-----------------------------------------------------
Fax | 386-427-0711
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. DANIEL FRANKLIN MILLER
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 386-427-4143
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | 44295
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------