Provider Demographics
NPI:1942330964
Name:MILAM, PHILLIP SCOTT (PT ATC)
Entity Type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:SCOTT
Last Name:MILAM
Suffix:
Gender:M
Credentials:PT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 LAKE HARBOR CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-3462
Mailing Address - Country:US
Mailing Address - Phone:407-240-2498
Mailing Address - Fax:
Practice Address - Street 1:100 W GORE ST
Practice Address - Street 2:300
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1044
Practice Address - Country:US
Practice Address - Phone:407-254-2558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT149492251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports