Miller, Jackie Robinson
Miller, Jackie Robinson is an individual health care provider with primary practice located at 701 W Plymouth Ave , Deland FL 32720-3236. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Miller, Jackie Robinson can be contacted via phone (386) 943-4522.Contact Information
Primary practice address
701 W Plymouth Ave
Deland FL 32720-3236
Phone: (386) 943-4522
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OS5051 | Florida |
Profile Details
NPI number | 1205899507 |
---|---|
LBN Legal business name | Miller, Jackie Robinson |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 8th, 2006 |
Last updated | Aug 3rd, 2009 - about 16 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1205899507 | NPPES |
Florida | Other | 57226 | BCBS |
Florida | MEDICAID | 250243700 | BCBS |
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