Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Miller

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1710418991

Ethan Miller is an Anesthesiology in St Augustine, Florida. Graduated from Wake Forest University School of Medicine in 2017, 9 years ago. Practices with Spartanburg Medical Center, a 1,067-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
9
Trained at
Wake Forest University School of Medicine
Licensed in
FL
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

400 Health Park Blvd
St Augustine, FL 32086-5784
Phone: (904) 200-5911
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence ME150027 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1710418991
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 21, 2017
Last updated in NPPESApril 28, 2021
Certification dateApril 28, 2021
Mailing address400 Health Park Blvd, St Augustine, FL 32086-5784

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolWAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Graduated 2017 (9 years in practice)
Group practice Spartanburg Medical Center — 1067 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in St Augustine