Provider Demographics
NPI:1760501282
Name:LUIS A MILLER MD PA
Entity type:Organization
Organization Name:LUIS A MILLER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MDPA
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:305-803-6580
Mailing Address - Street 1:PO BOX 561922
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-1922
Mailing Address - Country:US
Mailing Address - Phone:305-860-4850
Mailing Address - Fax:
Practice Address - Street 1:8260 W FLAGLER ST STE 2H
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2069
Practice Address - Country:US
Practice Address - Phone:305-229-0551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65522207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375295000Medicaid
FL375295000Medicaid