MEDICARE: BERNARD MILLER PT

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	208100000X	Physical Medicine & Rehabilitation Physician	0801	NV

General Provider Information

NPI Number	:	1205456803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNARD MILLER PT

Provider Business Mailing Address
First Line	:	981 WHITNEY RANCH DR APT 1624
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-2574
Country	:	US
Telephone Number	:	702-506-6819
Fax Number	:

Provider Business Practice Location Address
First Line	:	3645 EL CAMINO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-1102
Country	:	US
Telephone Number	:	702-888-3340
Fax Number	:

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

Provider Enumeration Date	:	04/23/2020
Last Update Date	:	04/23/2020

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Directions to “ BERNARD MILLER PT” Practice Location

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