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MILLENNIUM MEDICAL MANAGEMENT LLC NPI 1366645376


NPI Information

NPI: 1366645376
Provider Name: MILLENNIUM MEDICAL MANAGEMENT LLC

Doing Business As: DEUK SPINE INSTITUTE, PRIMARY CARE OF BREVARD, INJURY TREATMENT GROUP

Classification: Neurological Surgery - 207T00000X
Entity Type: Organization

CLIA Number: 10D1093121

Address:
7955 SPYGLASS HILL RD STE A
MELBOURNE, FL
ZIP 32940
Phone: (321) 255-6670
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MILLENNIUM MEDICAL MANAGEMENT LLC is a neurological surgery in Melbourne, FL. The provider is a neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. MILLENNIUM MEDICAL MANAGEMENT LLC NPI is 1366645376. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Deuk Spine Institute, Primary Care Of Brevard, Injury Treatment Group.

The provider's business location address is:

7955 SPYGLASS HILL RD STE A
MELBOURNE, FL
ZIP 32940-249
Phone: (321) 255-6670
Fax: (321) 242-2545

The provider's authorized official is Sun Mee Deukmedjian .
The authorized official title is Financial Officer and has the following contact phone number (321) 775-1290.

The CLIA number assigned to this NPI record is 10D1093121 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/7/2007 and was last updated on 3/17/2022.


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 License Number License State Primary
1207Q00000XFamily MedicineME84856FLORIDANo
2207X00000XOrthopaedic SurgeryME95180FLORIDANo
3207XS0114XOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryME95180FLORIDANo
4208100000XPhysical Medicine & RehabilitationME93866FLORIDANo
5208100000XPhysical Medicine & RehabilitationME111580FLORIDANo
6208100000XPhysical Medicine & RehabilitationOS12589FLORIDANo
72081P2900XPhysical Medicine & RehabilitationPain MedicineME93866FLORIDANo
82081P2900XPhysical Medicine & RehabilitationPain MedicineME111580FLORIDANo
92081P2900XPhysical Medicine & RehabilitationPain MedicineOS12589FLORIDANo
102081S0010XPhysical Medicine & RehabilitationSports MedicineME93866FLORIDANo
11208VP0014XPain MedicineInterventional Pain MedicineME93866FLORIDANo
12207T00000XNeurological SurgeryME82061FLORIDAYes
13363AS0400XPhysician AssistantSurgicalPA9105911FLORIDANo
14208VP0014XPain MedicineInterventional Pain MedicineME111580FLORIDANo
15261QM1200XClinic/CenterMagnetic Resonance Imaging (MRI)IAC ACCREDITED 7422FLORIDANo

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
13612958OTHERFLORIDAAETNA
2613998300OTHERFLORIDADOL ASC
3DG6510OTHERFLORIDAMEDICARE RAILROAD CARRIER
42921108OTHERFLORIDACIGNA
533435OTHERFLORIDABCBSFL

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: 5/5/2024

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