Basic Information
| Provider Information | |||||||||
| NPI: | 1558709386 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | VENECIA | ||||||||
| MiddleName: | ESTELA | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 308 S HARBOR CITY BLVD | ||||||||
| Address2: | SUITE C | ||||||||
| City: | MELBOURNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329011500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8635370848 | ||||||||
| FaxNumber: | 3217337970 | ||||||||
| Practice Location | |||||||||
| Address1: | 308 S HARBOR CITY BLVD | ||||||||
| Address2: | SUITE C | ||||||||
| City: | MELBOURNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329011500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8635370848 | ||||||||
| FaxNumber: | 3217337970 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2013 | ||||||||
| LastUpdateDate: | 06/14/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN9175866 | FL | Y | Nursing Service Providers | Registered Nurse | 163WR0006X | RN 9175866 | FL | N | Nursing Service Providers | Registered Nurse | Registered Nurse First Assistant | 372600000X | RN9175866 | FL | N | Nursing Service Related Providers | Adult Companion | 3747A0650X | RN9175866 | FL | N | Nursing Service Related Providers | Technician | Attendant Care Provider | 376J00000X | RN9175866 | FL | N | Nursing Service Related Providers | Homemaker |
No ID Information.