Provider Demographics
NPI:1699883538
Name:MILLER, DARRYL (MD)
Entity type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 OKEECHOBEE BLVD
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6349
Mailing Address - Country:US
Mailing Address - Phone:561-804-0200
Mailing Address - Fax:
Practice Address - Street 1:525 OKEECHOBEE BLVD
Practice Address - Street 2:SUITE 1400
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-6349
Practice Address - Country:US
Practice Address - Phone:561-804-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35075929M207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2361313Medicaid
000000325015OtherANTHEM
OH34192070200OtherBWC
7841380OtherAETNA HMO/NON HMO
OH34192070200OtherBWC
H65274Medicare UPIN