Active NPI
Philip T. Miner, MD
- Neurology Physician
- Orlando, FL
National Provider Identifier
1295845485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- ME122419
- Practice address
- 83 Columbia St
Orlando, FL 32806-1106 - Phone
- (321) 841-3050
- Fax
- (321) 843-3570
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Neurodevelopmental Disabilities Physician | 2080P0008X | 036-069826 | IL | |
| Neurology Physician | 2084N0400X | ME122419 | FL | Primary |
Addresses
Primary practice location
83 Columbia St
Orlando, FL 32806-1106
Mailing address
83 Columbia St
Orlando, FL 32806-1106
Phone (321) 841-3050
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019449400 | Medicaid | FL | |
| 036069826 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-069826 | IL | MD | Pediatric Neurodevelopmental Disabilities Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561680000000",
"number": "1295845485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "83 COLUMBIA ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328061106",
"telephone_number": "321-841-3050",
"fax_number": "321-843-3570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "83 COLUMBIA ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328061106",
"telephone_number": "321-841-3050",
"fax_number": "321-843-3570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINER",
"first_name": "PHILIP",
"middle_name": "T.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2019-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0008X",
"taxonomy_group": "",
"desc": "Pediatrics, Neurodevelopmental Disabilities",
"state": "IL",
"license": "036-069826",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "FL",
"license": "ME122419",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019449400",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036069826",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.