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NPI Code Detail

MEDICARE: MADELINE MILLER

MEDICARE: MADELINE MILLER
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
1106E00000XAssistant Behavior AnalystFL
2103K00000XBehavior Analyst1-25-82969FL

General Provider Information

NPI Number : 1215547278
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE MILLER
Provider Business Mailing Address
First Line : 2130 MORGAN WIELAND LN APT 15-107
Second Line :
City : LAKELAND
State : FL
Zip : 33813-3195
Country : US
Telephone Number : 800-686-5614
Fax Number :
Provider Business Practice Location Address
First Line : 4222 S FLORIDA AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33813-1628
Country : US
Telephone Number : 836-456-7148
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2020
Last Update Date : 07/28/2025

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Directions to “ MADELINE MILLER ” Practice Location

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