MEDICARE: DR. CHRISTINE P MILLER DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	PO3678	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	241402NSG	OTHER	PA	MEDICARE GROUP MEMBER PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104191063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE P MILLER DPM

Provider Business Mailing Address
First Line	:	13600 ICOT BLVD BLDG B
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33760-3703
Country	:	US
Telephone Number	:	888-290-6321
Fax Number	:	727-669-8417

Provider Business Practice Location Address
First Line	:	13600 ICOT BLVD BLDG B
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33760-3703
Country	:	US
Telephone Number	:	888-290-6321
Fax Number	:	727-669-8417

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2012
Last Update Date	:	12/06/2016

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Directions to “ DR. CHRISTINE P MILLER DPM” Practice Location

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