Organization
ALAN H MILES OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI JOHNSON (CONSULTANT)
(321) 956-0485
Entity
Organization
Contact information
Practice address
2000 S PATRICK DR, INDIAN HARBOUR BEACH, FL 32937-4462
(321) 777-1800
(321) 777-7504
Mailing address
1397 ASHFORD AVE NE, PALM BAY, FL 32907-1175
(321) 777-1800
(321) 777-7504
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1767
FL
332H00000X
Eyewear Supplier
OPC1767
FL
Other
Enumeration date
07/14/2011
Last updated
10/21/2011
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