Provider Demographics
NPI:1730253352
Name:MILLER, FLOREY (RD)
Entity type:Individual
Prefix:
First Name:FLOREY
Middle Name:
Last Name:MILLER
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-4514
Mailing Address - Country:US
Mailing Address - Phone:941-587-4142
Mailing Address - Fax:941-360-0035
Practice Address - Street 1:174 PINEHURST DR
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-4514
Practice Address - Country:US
Practice Address - Phone:941-587-4142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND2699133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN0171OtherBCBS
FLE8669Medicare ID - Type Unspecified