PHILIP MILLER MD PA
Ambulatory Health at Burns Rd, West Palm Beach, FL

License number
Florida ME34424
Category
Ambulatory Health
Type
Health Service
Owner
Name: DR. PHILIP MILLER MD
Title: PRESIDENT
Phone: (561) 691-3993
Address
Address
3385 Burns Rd SUITE 103, West Palm Beach, FL 33410
National Provider ID: 1164556387
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PHILIP MILLER, M.D., PA

Jupiter, FL  -  West Palm Beach, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Oct 8, 1984
Inactive since:
Sep 25, 2009
Addresses:
113 Bayberry Cir, Jupiter, FL 33458 (Physical)
5080 Pga Blvd, West Palm Beach, FL 33418
State ID:
H24394
Business type:
Florida Profit Corporation
Director, Vice Presidents:
Philip Miller President, Director, inactive, 113 Bayberry Cir, Jupiter, FL 33458 (Physical),Janis Miller Director, Vice President, inactive, 113 Bayberry Cir, Jupiter, FL 33458 (Physical)
Agent:
Miller, M.d. Philip,113 Bayberry Cir, Jupiter, FL 33458 (Physical)
EIN:
59-2450568

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