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Organization
MILLENNIUM PHYSICIAN GROUP LLC
Active
Organization
MILLENNIUM PHYSICIAN GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY HALTIGAN (DIRECTOR REVENUE CYCLE MANAGEMENT)
(877) 856-3774
Entity
Organization
Contact information
Practice address
6321 DANIELS PKWY, STE 201, FORT MYERS, FL 33912-4773
(855) 674-7401
(941) 258-3292
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
Other
Enumeration date
06/06/2013
Last updated
01/18/2023
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