Individual
GARY LEE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
311 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2781
(352) 273-8610
(352) 273-8612
Mailing address
PO BOX 100254, GAINESVILLE, FL 32610-0254
(352) 273-8610
(352) 273-8612
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
066569
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN1787402
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890360748B
—
GA
05
—
890360748C
—
GA
05
—
890360748E
—
GA
05
—
890360748F
—
GA
01
—
P00244931
RAILROAD MEDICARE
GA
Enumeration date
05/31/2006
Last updated
02/28/2022
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