Individual
HENRY E. MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
25 DELTONA BLVD., SUITE 1, ST. AUGUSTINE, FL 32086-4204
(904) 797-5760
(904) 797-5762
Mailing address
25 DELTONA BLVD, SUITE 1, ST AUGUSTINE, FL 32086-4204
(904) 797-5760
(904) 797-5762
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2080
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19013-Z
MEDICARE ID
FL
Enumeration date
07/19/2006
Last updated
02/19/2008
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