Basic Information
| Provider Information | |||||||||
| NPI: | 1447587662 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | EDWARD C MILLER OD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 260 CRANDON BLVD | ||||||||
| Address2: | 32-224 | ||||||||
| City: | KEY BISCAYNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331491536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549217470 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1780 STIRLING RD. #101 | ||||||||
| Address2: | |||||||||
| City: | DANIA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549209243 | ||||||||
| FaxNumber: | 9549205718 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2009 | ||||||||
| LastUpdateDate: | 03/18/2014 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | EDWARD | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9549217470 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | OD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | OPC1768 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.