Provider Demographics
NPI:1376507582
Name:MILLER, JOY ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:ELIZABETH
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6006 49TH ST N STE 310
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2149
Mailing Address - Country:US
Mailing Address - Phone:727-231-0846
Mailing Address - Fax:
Practice Address - Street 1:2901 W SWANN AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4057
Practice Address - Country:US
Practice Address - Phone:813-873-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2459363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3194557OtherCIGNA
FLY0RJ1OtherBCBS FL
P00077756OtherRAILROAD MEDICARE
FL290961800Medicaid
FLE8786WOtherQSS SCS PTAN
FLE8786WOtherQSS SCS PTAN
FLE2934YMedicare PIN
P00077756OtherRAILROAD MEDICARE
FLE8786ZMedicare PIN