Individual
DANIELLE N MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1223 GATEWAY DR STE 1E, MELBOURNE, FL 32901-2607
(321) 725-4505
(321) 409-8932
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106734
FL
363AM0700X
Medical Physician Assistant
085004152
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GS836Y
FL MEDICARE-
FL
01
—
P01165541
FL RR MEDICARE
FL
Enumeration date
10/14/2011
Last updated
03/10/2020
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