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General NPI Number Information
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NPI Number | 1669126488
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Entity Type | Organization
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Legal Business Name | YOUR FAVORITE NP CONSULTANT
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Dates
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Enumeration Date | 02/10/2022
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 757 CYPRESS GARDENS BLVD
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City | WINTER HAVEN
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State | FL
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Zip | 33880-4712
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Country | US
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Telephone | 863-268-6180
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Fax |
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Provider Business Mailing Address
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Address Line | 1651 MARSHALL RD SW
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City | WINTER HAVEN
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State | FL
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Zip | 33880-1955
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Country | US
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Telephone | 863-268-6180
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVIDA NICOLE MILLER
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Credential | FNP-C
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Telephone | 863-268-6180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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