MEDICARE: MS. RHONDA LYNN MILLER RDH

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	124Q00000X	Dental Hygienist	DH8826	FL

General Provider Information

NPI Number	:	1134417165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RHONDA LYNN MILLER RDH

Provider Business Mailing Address
First Line	:	1248 STONE HARBOUR RD
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708
Country	:	US
Telephone Number	:	407-803-2904
Fax Number	:	407-542-4634

Provider Business Practice Location Address
First Line	:	1248 STONE HARBOUR RD
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4739
Country	:	US
Telephone Number	:	407-803-2904
Fax Number	:	407-557-8446

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

Provider Enumeration Date	:	07/12/2011
Last Update Date	:	07/12/2011

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