Individual
DAVID MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC, CES
Contact information
Practice address
2951 VIRGINIA ST, MIAMI, FL 33133-3619
(610) 724-8715
Mailing address
2951 VIRGINIA ST, MIAMI, FL 33133-3619
(610) 724-8715
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0676
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT5409
STATE LICENSURE
FL
01
—
BOC218145
BOC
—
Enumeration date
07/21/2016
Last updated
02/18/2021
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