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NPI Code Detail

MEDICARE: LACEY MILLER

MEDICARE: LACEY 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
1103K00000XBehavior Analyst1-20-42649FL

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 : 1760907455
Entity Type Code : Individual
Provider Name (Legal Business Name) : LACEY MILLER
Provider Business Mailing Address
First Line : 495 GRAND BLVD STE 206
Second Line :
City : MIRAMAR BEACH
State : FL
Zip : 32550-1408
Country : US
Telephone Number : 470-350-4138
Fax Number : 321-250-7463
Provider Business Practice Location Address
First Line : 495 GRAND BOULEVARD
Second Line : SUITE 206
City : MIRAMAR BEACH
State : FL
Zip : 32550-1408
Country : US
Telephone Number : 855-832-6727
Fax Number : 772-675-9100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2017
Last Update Date : 03/04/2026

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