Provider Demographics
NPI:1982104899
Name:MILLER EMERGENCY MEDICINE, LLC
Entity Type:Organization
Organization Name:MILLER EMERGENCY MEDICINE, LLC
Other - Org Name:KEYS URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:WENDI
Authorized Official - Middle Name:S
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-850-5351
Mailing Address - Street 1:90290 OVERSEAS HWY STE 105
Mailing Address - Street 2:
Mailing Address - City:TAVERNIER
Mailing Address - State:FL
Mailing Address - Zip Code:33070-2263
Mailing Address - Country:US
Mailing Address - Phone:305-453-6097
Mailing Address - Fax:305-735-4014
Practice Address - Street 1:90290 OVERSEAS HWY STE 105
Practice Address - Street 2:
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070-2263
Practice Address - Country:US
Practice Address - Phone:305-453-6097
Practice Address - Fax:305-735-4014
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILLER EMERGENCY MEDICINE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-16
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No332900000XSuppliersNon-Pharmacy Dispensing Site