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

Kenneth Miller, PAC

Individual provider Physician Assistant · NPI 1891740015

Kenneth Miller, PAC is a Physician Assistant in Port Charlotte, Florida. Qualified in 1983, 43 years ago. Practices with Vijay Ganatra M D P A, a 13-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
43
Licensed in
FL
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

21297 Olean Blvd Ste A
Port Charlotte, FL 33952-6704
Phone: (855) 979-5700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2002 Del Prado Blvd S, Cape Coral, FL 33990-4557 — (239) 772-8900

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 00002039 (FL)

Record details

NPI number1891740015
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedMay 24, 2006
Last updated in NPPESDecember 2, 2019
Mailing address2675 Winkler Ave Fl 2, Fort Myers, FL 33901-9342

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1983 (43 years in practice)
Group practice Vijay Ganatra M D P A — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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