Provider Demographics
NPI:1497954333
Name:MILLER, CARLY B (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CARLY
Middle Name:B
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9555 N KENDALL DR STE 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1978
Mailing Address - Country:US
Mailing Address - Phone:305-596-5458
Mailing Address - Fax:305-598-9792
Practice Address - Street 1:9555 N KENDALL DR STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1978
Practice Address - Country:US
Practice Address - Phone:305-596-5458
Practice Address - Fax:305-598-9792
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12764225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics