Organization
G.L. MILLER ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY L MILLER CRNA (OWNER)
(407) 758-7101
Entity
Organization
Contact information
Practice address
561 W TROPIC WAY, SAINT AUGUSTINE, FL 32080-6402
(407) 758-7101
Mailing address
561 W TROPIC WAY, SAINT AUGUSTINE, FL 32080-6402
(407) 758-7101
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
06/19/2017
Last updated
07/21/2022
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