Provider Demographics
NPI:1235288424
Name:MILES, ALAN H (OD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:H
Last Name:MILES
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:1397 ASHFORD AVE NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-1175
Mailing Address - Country:US
Mailing Address - Phone:321-777-1800
Mailing Address - Fax:321-777-7504
Practice Address - Street 1:2000 S PATRICK DR
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4462
Practice Address - Country:US
Practice Address - Phone:321-777-1800
Practice Address - Fax:321-777-7504
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2011-10-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL152W00000X152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
T93890Medicare UPIN