Provider Demographics
NPI:1467588202
Name:MILLER CHIROPRACTIC & MEDICAL CENTERS, INC.
Entity Type:Organization
Organization Name:MILLER CHIROPRACTIC & MEDICAL CENTERS, INC.
Other - Org Name:PREMIER MILLER ORTHOPEDIC & MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-376-2841
Mailing Address - Street 1:720 E FLETCHER AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-2616
Mailing Address - Country:US
Mailing Address - Phone:813-903-2383
Mailing Address - Fax:
Practice Address - Street 1:1011 S US HIGHWAY 301
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-4903
Practice Address - Country:US
Practice Address - Phone:813-664-6934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC 4586261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC 4586OtherAHCA LICENSE