MEDICARE: MR. BISHOP LEE MCMILLER SR. RRT

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	227900000X	Registered Respiratory Therapist	RT942	FL

General Provider Information

NPI Number	:	1306934542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BISHOP LEE MCMILLER SR. RRT

Provider Business Mailing Address
First Line	:	602 NE BLUE RIDGE LANDING AVE
Second Line	:
City	:	LEE
State	:	FL
Zip	:	32059-4202
Country	:	US
Telephone Number	:	850-971-4350
Fax Number	:	850-971-4351

Provider Business Practice Location Address
First Line	:	602 NE BLUE RIDGE LANDING AVE
Second Line	:
City	:	LEE
State	:	FL
Zip	:	32059-4202
Country	:	US
Telephone Number	:	850-971-4350
Fax Number	:	850-971-4351

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	04/12/2026

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