Organization
YOUR FAVORITE NP CONSULTANT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVIDA NICOLE MILLER FNP-C (CEO)
(863) 268-6180
Entity
Organization
Contact information
Practice address
757 CYPRESS GARDENS BLVD, WINTER HAVEN, FL 33880-4712
(863) 268-6180
Mailing address
1651 MARSHALL RD SW, WINTER HAVEN, FL 33880-1955
(863) 268-6180
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
261QV0200X
VA Clinic/Center
—
—
305S00000X
Point of Service
—
—
Other
Enumeration date
02/10/2022
Last updated
04/22/2025
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