# JOHN R. MILES MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548651821
- **Authorized official:** JOHN ROBERT MILES MD (PRESIDENT)
- **Authorized official phone:** (813) 752-3174

## Contact information

- **Practice address:** 402 N DORT ST, PLANT CITY, FL 33563-4318
- **Practice address phone:** (813) 752-3174
- **Practice address fax:** (813) 659-3958
- **Mailing address:** 402 N DORT ST, PLANT CITY, FL 33563-4318
- **Mailing address phone:** (813) 752-3174
- **Mailing address fax:** (813) 659-3958

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | ME0041517 | FL | Yes |

## Other

- **Enumeration date:** 02/09/2015
- **Last updated:** 02/09/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 054796400 | — | FL |