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Individual

DR. MICHAEL LEE MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11 RACETRACK RD NE, SUITE E4, FORT WALTON BEACH, FL 32547-1882
(850) 200-4574
Mailing address
4607 CHANAN DRIVE, CRESTVIEW, FL 32539
(850) 682-2596

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
023433
LA
2086S0129X
Vascular Surgery Physician
Primary
ME98427
FL

Other

Enumeration date
03/16/2006
Last updated
01/09/2012
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