Look up the most recent NPI and PECOS records

Shaketra Miller

Behavior Analyst

Behavioral Health & Social Service Providers

4052 Eastridge Cir, Pompano Beach, FL 33064-1844

PECOS Enrollment

Based on the most recent information from CMS, provider Shaketra Miller does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1639533078
Provider Type
Individual
Full Name
Miller, Shaketra
Gender
Female

Sole Proprietor
No
Enumeration Date
4/12/2016
Last Updated
4/12/2016

Contact Information

Practice Location

4052 Eastridge Cir, Pompano Beach, FL 33064-1844

(786) 512-2960

Unlisted Fax

Mailing Location

4052 Eastridge Cir, Pompano Beach, FL 33064-1844

(786) 512-2960

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 103K00000X Primary	Description Behavior Analyst Behavioral Health & Social Service Providers	License 1-08-4450 Florida

Provider Identifiers

ID	Description	Issuer
ID 010797300	Description Medicaid	Issuer Unlisted Florida

Shaketra Miller

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Hermes, Angela M

Outside The Box Developmental Center

Raising Hope Aba Llc

Waldren, Audra

Thomas, Jamilia Shonta'

Adams, Latoya

Mendez, Nefris

Saik, Sarah

Abundant Abilities Llc

Petit Frere, Smana