Provider Demographics
NPI:1588990980
Name:SYLMA M MILLARES PA
Entity type:Organization
Organization Name:SYLMA M MILLARES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SYLMA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:MILLARES
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:786-325-0931
Mailing Address - Street 1:12204 SW 95TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1927
Mailing Address - Country:US
Mailing Address - Phone:786-325-0931
Mailing Address - Fax:305-271-8509
Practice Address - Street 1:12204 SW 95TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1927
Practice Address - Country:US
Practice Address - Phone:786-325-0931
Practice Address - Fax:305-271-8509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3277452363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002671000Medicaid