Basic Information
Provider Information
NPI: 1467046128
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILLER
FirstName: AARON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10865 NW 46TH DR
Address2:  
City: CORAL SPRINGS
State: FL
PostalCode: 330762130
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 8500 ROYAL PALM BLVD
Address2:  
City: CORAL SPRINGS
State: FL
PostalCode: 330655715
CountryCode: US
TelephoneNumber: 9547529500
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/23/2021
LastUpdateDate: 02/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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