Provider Demographics
NPI:1164671251
Name:MILLER, ANNJILL MEGALOS (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNJILL
Middle Name:MEGALOS
Last Name:MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5070 A1A
Mailing Address - Street 2:SUITE B
Mailing Address - City:INDIAN RIVER SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:32963-1400
Mailing Address - Country:US
Mailing Address - Phone:772-234-8956
Mailing Address - Fax:
Practice Address - Street 1:3012 NASSAU DR
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4991
Practice Address - Country:US
Practice Address - Phone:772-388-4842
Practice Address - Fax:772-234-5403
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor