Letha F Miller, Inc. | |
4244 Central Ave Saint Petersburg FL 33711-1140 | |
(727) 303-7854 | |
Not Available |
Full Name | Letha F Miller, Inc. |
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Speciality | Community/Behavioral Health |
Location | 4244 Central Ave, Saint Petersburg, Florida |
Authorized Official Name and Position | Letha Faye Miller (OWNER) |
Authorized Official Contact | 7273037854 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Letha F Miller, Inc. 6408 1st Ave S Saint Petersburg FL 33707-1302 Ph: (727) 303-7854 | Letha F Miller, Inc. 4244 Central Ave Saint Petersburg FL 33711-1140 Ph: (727) 303-7854 |
NPI Number | 1588289680 |
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Provider Enumeration Date | 06/15/2020 |
Last Update Date | 06/15/2020 |
Certification Date | 06/15/2020 |
Medicare PECOS PAC ID | 2062837602 |
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Medicare Enrollment ID | O20200730000818 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588289680 | NPI | - | NPPES |
SW7745 | Other | FL | STATE OF FL - DEPT OF HEALTH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Letha Faye Miller |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1538373865 PECOS PAC ID: 6608928973 Enrollment ID: I20090716000737 |
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