Provider Demographics
NPI:1104950609
Name:MILEY, FREDERICK GEORGE II (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:GEORGE
Last Name:MILEY
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2078
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-2078
Mailing Address - Country:US
Mailing Address - Phone:352-629-4448
Mailing Address - Fax:352-867-7015
Practice Address - Street 1:2100 SE 17TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4196
Practice Address - Country:US
Practice Address - Phone:352-629-4448
Practice Address - Fax:352-867-7015
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 137222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD 54876Medicare UPIN
44084Medicare ID - Type Unspecified