Provider Demographics
NPI:1043211964
Name:MILLAR, ANN MARIE (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANN MARIE
Middle Name:
Last Name:MILLAR
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 NW 14TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125
Mailing Address - Country:US
Mailing Address - Phone:305-710-0725
Mailing Address - Fax:786-363-8820
Practice Address - Street 1:1609 NW 14TH AVENUE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-710-0725
Practice Address - Fax:786-363-8820
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2402213E00000X
FLP02402213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390481400Medicaid
FL390481400Medicaid
FLU515181Medicare UPIN
U51581Medicare UPIN