| Kimberly J Miller Psyd Inc | |
|
1505 Tamiami Trl S Ste 401a Venice FL 34285-5562 | |
| (941) 504-6980 | |
| Not Available |
| Full Name | Kimberly J Miller Psyd Inc |
|---|---|
| Speciality | Psychologist |
| Location | 1505 Tamiami Trl S Ste 401a, Venice, Florida |
| Authorized Official Name and Position | Kimberly J Miller (OWNER) |
| Authorized Official Contact | 9415046980 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly J Miller Psyd Inc 1328 Loma Linda Ct Sarasota FL 34239-2426 Ph: (941) 504-6980 | Kimberly J Miller Psyd Inc 1505 Tamiami Trl S Ste 401a Venice FL 34285-5562 Ph: (941) 504-6980 |
| NPI Number | 1447941026 |
|---|---|
| Provider Enumeration Date | 05/16/2023 |
| Last Update Date | 05/16/2023 |
| Certification Date | 05/16/2023 |
| Medicare PECOS PAC ID | 6305205899 |
|---|---|
| Medicare Enrollment ID | O20230630001353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447941026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kimberly J Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285325852 PECOS PAC ID: 9830558337 Enrollment ID: I20230630001474 |
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