Provider Demographics
NPI:1275785255
Name:MILLER, VENUS M (DNP,APRN,FNP,PMHP-BC)
Entity Type:Individual
Prefix:MS
First Name:VENUS
Middle Name:M
Last Name:MILLER
Suffix:
Gender:F
Credentials:DNP,APRN,FNP,PMHP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27415 SW 143RD CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8875
Mailing Address - Country:US
Mailing Address - Phone:786-525-9587
Mailing Address - Fax:
Practice Address - Street 1:22790 SW 112TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-7602
Practice Address - Country:US
Practice Address - Phone:305-235-2626
Practice Address - Fax:305-235-6178
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2526452363LF0000X
FLAPRN2526452363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004175101Medicaid
FL004175100OtherMEDICAID-SPECIALITY CODE -76-PSYCH MENTAL HEALTH CARE
FLBG245ZMedicare PIN