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NPI Code Detail

MEDICARE: CRAIG LOUIS MILLER RBT

MEDICARE: CRAIG LOUIS MILLER RBT
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
1106S00000XBehavior TechnicianFL

General Provider Information

NPI Number : 1316569080
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRAIG LOUIS MILLER RBT
Provider Business Mailing Address
First Line : 3108 MANDEVILLE ST
Second Line :
City : DELTONA
State : FL
Zip : 32738-2167
Country : US
Telephone Number : 386-789-5222
Fax Number :
Provider Business Practice Location Address
First Line : 454 FORT FLORIDA RD
Second Line :
City : DEBARY
State : FL
Zip : 32713-9714
Country : US
Telephone Number : 386-562-0170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2020
Last Update Date : 05/15/2020

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Directions to “ CRAIG LOUIS MILLER RBT” Practice Location

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