Provider Demographics
NPI:1043240393
Name:MILES, VALERIE HEATH (MD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:HEATH
Last Name:MILES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5758 TANGLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-7034
Mailing Address - Country:US
Mailing Address - Phone:904-725-3295
Mailing Address - Fax:
Practice Address - Street 1:1539 PARENTAL HOME RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-3009
Practice Address - Country:US
Practice Address - Phone:904-338-0434
Practice Address - Fax:904-425-0821
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79205208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260109500Medicaid