| John R. Miles Md Pa | |
|
402 N Dort St Plant City FL 33563-4318 | |
| (813) 752-3174 | |
| (813) 659-3958 |
| Full Name | John R. Miles Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 402 N Dort St, Plant City, Florida |
| Authorized Official Name and Position | John Robert Miles (PRESIDENT) |
| Authorized Official Contact | 8137523174 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John R. Miles Md Pa 402 N Dort St Plant City FL 33563-4318 Ph: (813) 752-3174 | John R. Miles Md Pa 402 N Dort St Plant City FL 33563-4318 Ph: (813) 752-3174 |
| NPI Number | 1548651821 |
|---|---|
| Provider Enumeration Date | 02/09/2015 |
| Last Update Date | 02/09/2015 |
| Medicare PECOS PAC ID | 1557689502 |
|---|---|
| Medicare Enrollment ID | O20150423000806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548651821 | NPI | - | NPPES |
| 054796400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME0041517 (Florida) | Primary |
| Provider Name | John R Miles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619975190 PECOS PAC ID: 0941484455 Enrollment ID: I20110407000405 |
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