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MILLENNIUM PHYSICIAN GROUP LLC NPI 1720750417


NPI Information

NPI: 1720750417
Provider Name: MILLENNIUM PHYSICIAN GROUP LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 10D0688318

Address:
11513 N MAIN ST
JACKSONVILLE, FL
ZIP 32218
Phone: (904) 751-6200
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MILLENNIUM PHYSICIAN GROUP LLC is a family medicine in Jacksonville, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MILLENNIUM PHYSICIAN GROUP LLC NPI is 1720750417. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

11513 N MAIN ST
JACKSONVILLE, FL
ZIP 32218-002
Phone: (904) 751-6200
Fax: (904) 751-1600

The provider's authorized official is Mary Haltigan .
The authorized official title is Director Of Revenue Cycle and has the following contact phone number (877) 856-3774.

The CLIA number assigned to this NPI record is 10D0688318 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/30/2021 and was last updated on 1/19/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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