Provider Demographics
NPI:1053769117
Name:MILLER, SANDRA LUCIA (DPT)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LUCIA
Last Name:MILLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 SW 69 AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317
Mailing Address - Country:US
Mailing Address - Phone:954-888-6650
Mailing Address - Fax:954-888-6645
Practice Address - Street 1:10392 WEST STATE ROAD 84
Practice Address - Street 2:SUITE 106
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324
Practice Address - Country:US
Practice Address - Phone:754-206-3046
Practice Address - Fax:954-543-7300
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT29492225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist