Sukati Lee Miller, CNA

Individual provider Active NPI Home Health Agency · Midway, FL

NPI 1740423656 · NPPES record last updated Jul 22, 2014

Key facts

NPI
1740423656
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Agency 251E00000X
License
343453230813E (NY)
Practice address
33870 Blue Star Hwy Apt 903
Midway, FL 32343-2433
Phone
(315) 395-9010
NPI assigned
Apr 8, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
343453230813ENYMDHome Health Agency
132716RSCMDNurse's Aide

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 132716R SC
Home Health Agency 251E00000X 343453230813E NY Yes

Addresses

Primary practice location

33870 Blue Star Hwy Apt 903
Midway, FL 32343-2433

Mailing address

33870 Blue Star Hwy Apt 903
Midway, FL 32343-2433
Phone (315) 395-9010

Other providers in Midway, FL

All providers in Midway, FL · Home Health Agency in Florida

Sources for this page

Verify at the official NPI Registry.