Basic Information
| Provider Information | |||||||||
| NPI: | 1184987828 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | MICHAL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 33 LEWIS RD | ||||||||
| Address2: | 2ND FL | ||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077298156 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7225 N UNIVERSITY DR STE 210 | ||||||||
| Address2: | |||||||||
| City: | TAMARAC | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333212908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544841710 | ||||||||
| FaxNumber: | 9544847882 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2012 | ||||||||
| LastUpdateDate: | 04/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | NY-279103-A | NE | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | ME128125 | FL | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 279103 | NY | N | Allopathic & Osteopathic Physicians | Hospitalist | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | ME128125 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.