| Earl Norman Miller Iii, PA-C | |
|
10475 Centurion Pkwy N Ste 301, Jacksonville, FL 32256-5004 | |
| (904) 634-0640 | |
| (904) 634-0203 |
| Full Name | Earl Norman Miller Iii |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 28 Years |
| Location | 10475 Centurion Pkwy N Ste 301, Jacksonville, Florida |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962474890 | NPI | - | NPPES |
| 2909928-00 | Medicaid | FL | |
| Y03P5 | Other | FL | BCBS |
| 363707110A | Medicaid | GA | |
| 108011300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9100657 (Florida) | Primary |
| 363AS0400X | Physician Assistant - Surgical | (NU) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Brooks Rehabilitation Home Health | Jacksonville, FL | Home health agency |
| Ascension St Vincent's Southside | Jacksonville, FL | Hospital |
| Brooks Rehabilitation Hospital University Campus | Jacksonville, FL | Inpatient rehabilitation facility |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southeast Orthopedic Specialists Llc | 1456246974 | 144 |
| Lake Area Physical Therapy Inc. | 3678604840 | 372 |
| Entity Name | Southeast Orthopedic Specialists LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629025820 PECOS PAC ID: 1456246974 Enrollment ID: O20040216000301 |
| Mailing Address | Practice Location Address |
|---|---|
| Earl Norman Miller Iii, PA-C 6800 Southpoint Pkwy Ste 300, Jacksonville, FL 32216-8203 Ph: (904) 634-0640 | Earl Norman Miller Iii, PA-C 10475 Centurion Pkwy N Ste 301, Jacksonville, FL 32256-5004 Ph: (904) 634-0640 |
Katherine L Walsh, PA-C/MPH Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 |
Teresa Louise Cowan, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1200 Riverplace Blvd, Suite 620, Jacksonville, FL 32207 Phone: 904-396-6620 Fax: 904-396-6528 |
Mrs. Melina Volner Sommese, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2594 Fax: 904-953-6225 |
Mr. Thomas Matthew Mattox Jr., PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 15255 Max Leggett Pkwy Ste 5500, Jacksonville, FL 32218 Phone: 904-223-3321 |
Kyle Hollingsworth, PA-C, ATC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 710 Lomax St, Jacksonville, FL 32204 Phone: 904-355-6583 |
Jessica Defazio, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 836 Prudential Dr Ste 1400, Jacksonville, FL 32207 Phone: 904-388-6518 Fax: 904-384-1005 |
Hangyu Shen Watson, M.D. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 |