Miller, Ethan

Miller, Ethan is an individual health care provider with primary practice located at 400 Health Park Blvd , St Augustine FL 32086-5784. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Miller, Ethan can be contacted via phone (904) 200-5911.

Contact Information

Primary practice address
400 Health Park Blvd St Augustine FL 32086-5784
Phone: (904) 200-5911
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X ME150027 Florida

Profile Details

NPI number 1710418991
LBN Legal business name Miller, Ethan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2017
Last updated Apr 28th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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