Provider Demographics
NPI:1558374579
Name:MICHAEL A MILLER DC PA
Entity Type:Organization
Organization Name:MICHAEL A MILLER DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-668-4200
Mailing Address - Street 1:3116 CAPITAL CIR NE STE 1
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-7791
Mailing Address - Country:US
Mailing Address - Phone:850-668-4200
Mailing Address - Fax:850-878-3141
Practice Address - Street 1:3116 CAPITAL CIR NE STE 1
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-7791
Practice Address - Country:US
Practice Address - Phone:850-668-4200
Practice Address - Fax:850-878-3141
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHAEL A MILLER DC PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-14
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3821030 00Medicaid