| Entity Name: | DAVID B. MILLER, PSY. D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 21 Oct 2004 (20 years ago) |
| Document Number: | P04000145411 |
| FEI/EIN Number | 34-2023663 |
| Address: | 5295 TOWN CENTER RD, SUITE 401, BOCA RATON, FL 33486 |
| Mail Address: | 5295 TOWN CENTER RD, SUITE 401, BOCA RATON, FL 33486 |
| ZIP code: | 33486 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063695278 | 2007-12-11 | 2010-01-06 | 5295 TOWN CENTER RD, SUITE 401, BOCA RATON, FL, 334861080, US | 5295 TOWN CENTER RD, SUITE 401, BOCA RATON, FL, 334861080, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 561-362-3739 |
| Fax | 5613625595 |
Authorized person
| Name | DAVID B MILLER |
| Role | PRESIDENT/PSYCHOLOGIST |
| Phone | 5613623739 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | PY6648 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS FL |
| Number | 74496 |
| State | FL |
| Issuer | INDIVIDUAL NPI |
| Number | 1902851678 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MILLER, DAVID B | Agent | 5295 TOWN CENTER RD, 401, BOCA RATON, FL 33486 |
| Name | Role | Address |
|---|---|---|
| MILLER, DAVID B | PSYD | 5295 TOWN CENTER RD #401, BOCA RATON, FL 33486 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2010-01-20 | 5295 TOWN CENTER RD, SUITE 401, BOCA RATON, FL 33486 | No data |
| CHANGE OF MAILING ADDRESS | 2010-01-20 | 5295 TOWN CENTER RD, SUITE 401, BOCA RATON, FL 33486 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-01-20 | 5295 TOWN CENTER RD, 401, BOCA RATON, FL 33486 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-15 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-02-08 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-04-14 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-07-06 |
| ANNUAL REPORT | 2016-01-24 |
| ANNUAL REPORT | 2015-01-19 |
Date of last update: 29 Jan 2025
Sources: Florida Department of State
