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Individual

DAVID E. MILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
25 DELTONA BLVD., SUITE 1, ST. AUGUSTINE, FL 32086-7020
(904) 797-5760
(904) 797-5762
Mailing address
25 DELTONA BLVD., SUITE 1, ST. AUGUSTINE, FL 32086-7020
(904) 797-5760
(904) 797-5762

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1589
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19870-Z
MEDICARE ID
FL
Enumeration date
07/19/2006
Last updated
02/08/2008
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