Miller Vascular, PA

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

ME98427 Issued in FL

Legal business name

MILLER VASCULAR, PA

Practice address

11 Racetrack Rd NE
Suite E4
Fort Walton Beach, FL 32547-1882

Phone

(850) 200-4574

Fax

(850) 200-4576

NPI assigned

Jan 9, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael Lee Miller, M.D.

Title

President

Phone

(850) 398-7088

Specialties & licenses 1

Addresses

Other names 1

• Emaerald Coast Vein Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1427328343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4607 CHANAN DR",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325394341",
            "telephone_number": "850-682-2596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RACETRACK RD NE",
            "address_2": "SUITE E4",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471882",
            "telephone_number": "850-200-4574",
            "fax_number": "850-200-4576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLER VASCULAR, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-398-7088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "ME98427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emaerald Coast Vein Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Wildman, Occupational Therapist, P.a.
• Mid-South Home Care Services, Inc.
• Victoria Ann Miles-Nance
• Jessica L Millard, DO
• Shannon Miller Lehman, RDN
• Brittany Miller, APRN
• D'Lane Sally Miller, PH.D.
• Don E Miller, CRNA
• Michael Lee Miller, M.D.
• Heather Mills, OTR/L

• Ambulatory Surgical Clinic/Center in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.