Provider Demographics
NPI:1427709047
Name:MILLER, VANESSA ANN (PHARMACIST)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 SW 180TH TER
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5217
Mailing Address - Country:US
Mailing Address - Phone:954-559-7834
Mailing Address - Fax:954-433-7276
Practice Address - Street 1:1803 SW 180TH TER
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5217
Practice Address - Country:US
Practice Address - Phone:954-559-7834
Practice Address - Fax:954-433-7276
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS20068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist