Individual
ANDREA LEE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12470 TELECOM DR STE 300W, TEMPLE TERRACE, FL 33637-0904
(813) 871-8200
(813) 357-5501
Mailing address
12470 TELECOM DR STE 300W, TEMPLE TERRACE, FL 33637-0904
(813) 871-8200
(813) 357-5501
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
ME94134
FL
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
ME94134
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275306500
—
FL
01
—
76094
BCBS
FL
01
—
ME94134
MD LICENSE
FL
01
—
P02212301
RAILROAD MEDICARE
FL
Enumeration date
06/27/2006
Last updated
03/07/2023
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