Provider Demographics
NPI:1902831787
Name:MILLER, SEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34995-0417
Mailing Address - Country:US
Mailing Address - Phone:772-223-2832
Mailing Address - Fax:772-223-5653
Practice Address - Street 1:200 SE HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2346
Practice Address - Country:US
Practice Address - Phone:772-223-5618
Practice Address - Fax:772-288-5834
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-7485207R00000X
FLME105658208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL148W1OtherFLORIDA BLUE
OHMI4155113Medicare PIN
OHH35838Medicare UPIN
FL148W1OtherFLORIDA BLUE
OHMI4047987Medicare PIN
OHMI4047986Medicare ID - Type UnspecifiedMILFORD PIN
OHMI4155111Medicare PIN
OHMI4047989Medicare ID - Type UnspecifiedCOLERAIN PIN
OHMI4155112Medicare ID - Type UnspecifiedDAYTON PIN