Individual provider Active NPI

Gary Bruce Miller, D.C.

  • Chiropractor
  • Kissimmee, FL
National Provider Identifier
1972711240
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6390 Issued in FL
Practice address
1200 N Central Ave
Suite 112
Kissimmee, FL 34741-4450
Phone
(407) 931-0051
Fax
(407) 931-2789
NPI assigned
May 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH6390 FL Primary

Addresses

Primary practice location

1200 N Central Ave
Suite 112
Kissimmee, FL 34741-4450

Mailing address

5883 NE 61St Avenue Rd
Silver Springs, FL 34488-1243
Phone (352) 236-5790

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CH6390FLMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1179532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972711240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5883 NE 61ST AVENUE RD",
            "city": "SILVER SPRINGS",
            "state": "FL",
            "postal_code": "344881243",
            "telephone_number": "352-236-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N CENTRAL AVE",
            "address_2": "SUITE 112",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414450",
            "telephone_number": "407-931-0051",
            "fax_number": "407-931-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "GARY",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.