Provider Demographics
NPI:1245271337
Name:MILLER, HOLLY RAASS (MD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:RAASS
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 MEDICAL BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1413
Mailing Address - Country:US
Mailing Address - Phone:239-513-0053
Mailing Address - Fax:239-596-0900
Practice Address - Street 1:1660 MEDICAL BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1413
Practice Address - Country:US
Practice Address - Phone:239-513-0053
Practice Address - Fax:239-596-0900
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD40957207V00000X
FLME104443207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3812875Medicaid
TN38128751Medicare PIN
TN3812875Medicaid