MILLENIUM MEDICAL GROUP CORP. NPI 1093287377

NPI Information

NPI: 1093287377
Provider Name: MILLENIUM MEDICAL GROUP CORP.
Classification: Family Medicine - 207QA0505X
Specialization: Adult Medicine
Entity Type: Organization
Address: 2720 SW 97TH AVE STE C105
MIAMI, FL
ZIP 33165
Phone: (786) 332-4330

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NPI Details

MILLENIUM MEDICAL GROUP CORP. is an adult medicine family medicine in Miami, FL. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. MILLENIUM MEDICAL GROUP CORP. NPI is 1093287377. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2720 SW 97TH AVE STE C105
MIAMI, FL
ZIP 33165-677
Phone: (786) 332-4330
Fax: (786) 332-4109

The provider's authorized official is Damarys Quiriello .
The authorized official title is President and has the following contact phone number (786) 332-4330.

The enumeration date for this NPI number is 12/26/2018 and was last updated on 3/6/2025.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YM0800X	Counselor	Mental Health	No
2	1041C0700X	Social Worker	Clinical	No
3	207QA0505X	Family Medicine	Adult Medicine	Yes
4	2084P0800X	Psychiatry & Neurology	Psychiatry	No
5	251S00000X	Community/Behavioral Health		No
6	261Q00000X	Clinic/Center		No
7	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	023735400	MEDICAID	FLORIDA

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: 3/30/2025

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