Miller, Victoria O

Miller, Victoria O is an individual health care provider with primary practice located at 493 Prosperity Lake Dr , St Augustine FL 32092-5045. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Miller, Victoria O can be contacted via phone (904) 824-5437.

Contact Information

Primary practice address
493 Prosperity Lake Dr St Augustine FL 32092-5045
Phone: (904) 824-5437
Fax: (904) 824-7575
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9100960 Florida

Profile Details

NPI number 1316946866
LBN Legal business name Miller, Victoria O
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated May 17th, 2012 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1316946866 NPPES
Florida MEDICAID 290572800

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