Individual
GLORIA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2217 PERRY PL, 2217 PERRY PLACE, JACKSONVILLE, FL 32207-3465
(904) 398-0734
(904) 399-4146
Mailing address
2217 PERRY PL, JACKSONVILLE, FL 32207-3465
(904) 398-0734
(904) 399-4146
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL11371
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
693050696
—
FL
Enumeration date
03/25/2014
Last updated
03/25/2014
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