Provider Demographics
NPI:1306934542
Name:MCMILLER, BISHOP LEE SR (RRT)
Entity type:Individual
Prefix:MR
First Name:BISHOP
Middle Name:LEE
Last Name:MCMILLER
Suffix:SR
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 NE BLUE RIDGE LANDING AVE
Mailing Address - Street 2:
Mailing Address - City:LEE
Mailing Address - State:FL
Mailing Address - Zip Code:32059-4202
Mailing Address - Country:US
Mailing Address - Phone:850-971-4350
Mailing Address - Fax:850-971-4351
Practice Address - Street 1:602 NE BLUE RIDGE LANDING AVE
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:FL
Practice Address - Zip Code:32059-4202
Practice Address - Country:US
Practice Address - Phone:850-971-4350
Practice Address - Fax:850-971-4351
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT942227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE1873Medicare ID - Type Unspecified