Provider Demographics
NPI:1861689853
Name:MURRAY J MILLER, MD, PA
Entity Type:Organization
Organization Name:MURRAY J MILLER, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MURRAY
Authorized Official - Middle Name:JACK
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-739-1214
Mailing Address - Street 1:3001 NW 49TH AVE
Mailing Address - Street 2:SUITE #305
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313-7266
Mailing Address - Country:US
Mailing Address - Phone:954-739-1214
Mailing Address - Fax:954-739-1256
Practice Address - Street 1:3001 NW 49TH AVE
Practice Address - Street 2:SUITE #305
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-7266
Practice Address - Country:US
Practice Address - Phone:954-739-1214
Practice Address - Fax:954-739-1256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269633900Medicaid
K4378Medicare PIN