| Letha F Miller, Inc. | |
|
4244 Central Ave Saint Petersburg FL 33711-1140 | |
| (727) 303-7854 | |
| Not Available |
| Full Name | Letha F Miller, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4244 Central Ave, Saint Petersburg, Florida |
| Authorized Official Name and Position | Letha Faye Miller (OWNER) |
| Authorized Official Contact | 7273037854 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Letha F Miller, Inc. 6408 1st Ave S Saint Petersburg FL 33707-1302 Ph: (727) 303-7854 | Letha F Miller, Inc. 4244 Central Ave Saint Petersburg FL 33711-1140 Ph: (727) 303-7854 |
| NPI Number | 1588289680 |
|---|---|
| Provider Enumeration Date | 06/15/2020 |
| Last Update Date | 06/15/2020 |
| Certification Date | 06/15/2020 |
| Medicare PECOS PAC ID | 2062837602 |
|---|---|
| Medicare Enrollment ID | O20200730000818 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588289680 | NPI | - | NPPES |
| SW7745 | Other | FL | STATE OF FL - DEPT OF HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Letha Faye Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538373865 PECOS PAC ID: 6608928973 Enrollment ID: I20090716000737 |
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