Provider Demographics
NPI:1346581634
Name:MILLER, KATHRYN ELAINE (DO, MBA)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ELAINE
Last Name:MILLER
Suffix:
Gender:F
Credentials:DO, MBA
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Mailing Address - Street 1:11195 S JOG RD STE 1&2
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-1829
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11195 S JOG RD STE 1&2
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-1829
Practice Address - Country:US
Practice Address - Phone:561-752-0075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO3322207W00000X
FLOS13933207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology