Provider Demographics
NPI:1154940716
Name:GILMAN, MILES (PHARMD)
Entity type:Individual
Prefix:
First Name:MILES
Middle Name:
Last Name:GILMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 SW 12TH AVE STE 101D
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-3114
Mailing Address - Country:US
Mailing Address - Phone:888-327-2233
Mailing Address - Fax:
Practice Address - Street 1:160 SW 12TH AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-3119
Practice Address - Country:US
Practice Address - Phone:888-327-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL191291835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19129OtherFLORIDA BOARD OF PHARMACY