Organization
MILLER VASCULAR, PA
Active
Other names
Emaerald Coast Vein Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL LEE MILLER M.D. (PRESIDENT)
(850) 398-7088
Entity
Organization
Contact information
Practice address
11 RACETRACK RD NE, SUITE E4, FORT WALTON BEACH, FL 32547-1882
(850) 200-4574
(850) 200-4576
Mailing address
4607 CHANAN DR, CRESTVIEW, FL 32539-4341
(850) 682-2596
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
ME98427
FL
Other
Enumeration date
01/09/2012
Last updated
01/09/2012
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