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NPI Code Detail

MEDICARE: TAYLOR RENEE MILLER

MEDICARE:   TAYLOR RENEE 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
1106S00000XBehavior TechnicianFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356981120
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR RENEE MILLER
Provider Business Mailing Address
First Line : 12300 GOLDEN KNIGHT CIR APT 31-203D
Second Line :
City : ORLANDO
State : FL
Zip : 32817-8307
Country : US
Telephone Number : 815-409-5999
Fax Number :
Provider Business Practice Location Address
First Line : 12300 GOLDEN KNIGHT CIR APT 31-203D
Second Line :
City : ORLANDO
State : FL
Zip : 32817-8307
Country : US
Telephone Number : 815-409-5999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2020
Last Update Date : 01/09/2020

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Directions to “ TAYLOR RENEE MILLER ” Practice Location

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