Provider Demographics
NPI:1912420050
Name:MILLER, CAMERON GAY (PA-C)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:GAY
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:20254 ROYAL VILLAGIO CT UNIT 102
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-3138
Mailing Address - Country:US
Mailing Address - Phone:859-351-9152
Mailing Address - Fax:
Practice Address - Street 1:15821 HOLLYFERN CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3732
Practice Address - Country:US
Practice Address - Phone:239-432-5100
Practice Address - Fax:239-432-0629
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-20
Last Update Date:2018-03-17
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant