Provider Demographics
NPI:1841242690
Name:MILLER, TODD D (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:D
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 10744
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33757-0744
Mailing Address - Country:US
Mailing Address - Phone:727-532-0002
Mailing Address - Fax:
Practice Address - Street 1:8787 BRYAN DAIRY RD
Practice Address - Street 2:# 320
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1251
Practice Address - Country:US
Practice Address - Phone:727-394-5901
Practice Address - Fax:813-635-2693
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86694207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268152800Medicaid
FLP00077915OtherRAILROAD MEDICARE
FLP00077915OtherRAILROAD MEDICARE
H93241Medicare UPIN