Provider Demographics
NPI:1649200023
Name:MILLER, ALAN KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:KEITH
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 3RD AVE W STE 110
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8628
Mailing Address - Country:US
Mailing Address - Phone:941-421-5999
Mailing Address - Fax:941-960-8707
Practice Address - Street 1:200 3RD AVE W STE 110
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8628
Practice Address - Country:US
Practice Address - Phone:941-421-5999
Practice Address - Fax:941-960-8707
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301512961208800000X
FLME80500208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P02788299OtherMEDICARE RAILROAD
FLWAMW4OtherBCBS FL
FL012606800Medicaid
FLP512317OtherOPTIMUM
FL353769OtherAVMED
FL7122356OtherAETNA
FLP01040808OtherRAILROAD MCR
FL1193409OtherWELLCARE
FL81883OtherBCBS FL
FLP01040808OtherRAILROAD MCR
FL127097OtherUNIVERSAL