Provider Demographics
NPI:1942417571
Name:MILLER, PAUL N (MS)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:N
Last Name:MILLER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 SCHOONER DR
Mailing Address - Street 2:
Mailing Address - City:LABELLE
Mailing Address - State:FL
Mailing Address - Zip Code:33935-5308
Mailing Address - Country:US
Mailing Address - Phone:863-675-4432
Mailing Address - Fax:
Practice Address - Street 1:601 W ALVERDEZ AVE
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-3504
Practice Address - Country:US
Practice Address - Phone:863-983-1423
Practice Address - Fax:863-983-1426
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health