Provider Demographics
NPI:1588866495
Name:CHRISTOPHER J MILLER O.D.P.A
Entity type:Organization
Organization Name:CHRISTOPHER J MILLER O.D.P.A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-745-6463
Mailing Address - Street 1:250 S CENTRAL BLVD
Mailing Address - Street 2:STE 107
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8812
Mailing Address - Country:US
Mailing Address - Phone:561-745-6463
Mailing Address - Fax:561-748-3001
Practice Address - Street 1:250 S CENTRAL BLVD
Practice Address - Street 2:STE 107
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-8812
Practice Address - Country:US
Practice Address - Phone:561-745-6463
Practice Address - Fax:561-748-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2723152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU33202Medicare UPIN
FLK7160Medicare ID - Type Unspecified