Provider Demographics
NPI:1659339109
Name:MILLER, SCOTT EVAN (MPT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:EVAN
Last Name:MILLER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 SE 6TH AVE
Mailing Address - Street 2:UNIT 2
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5226
Mailing Address - Country:US
Mailing Address - Phone:954-649-3414
Mailing Address - Fax:561-278-6670
Practice Address - Street 1:247 SE 6TH AVE.
Practice Address - Street 2:UNIT #2
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483
Practice Address - Country:US
Practice Address - Phone:561-278-6055
Practice Address - Fax:561-278-6670
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21309225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist