Provider Demographics
NPI:1033246194
Name:MILLER, MARGARET J (PA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:J
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16124
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33416-6124
Mailing Address - Country:US
Mailing Address - Phone:561-371-8105
Mailing Address - Fax:
Practice Address - Street 1:861 SW 78TH AVE
Practice Address - Street 2:SUITE #100B
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3273
Practice Address - Country:US
Practice Address - Phone:877-693-5700
Practice Address - Fax:954-693-0005
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2063363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01305Medicare UPIN