Provider Demographics
NPI:1235107111
Name:MILLER, ELIZABETH K (ARNP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:K
Last Name:MILLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2945
Mailing Address - Country:US
Mailing Address - Phone:941-365-0433
Mailing Address - Fax:941-954-2064
Practice Address - Street 1:1851 HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2945
Practice Address - Country:US
Practice Address - Phone:941-365-0433
Practice Address - Fax:941-954-2064
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3247622363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP31296Medicare UPIN
FLE5516XMedicare ID - Type Unspecified