# MILLENNIUM PHYSICIAN GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497181341
- **Authorized official:** MARY HALTIGAN (DIRECTOR REVENUE CYCLE MNGMT)
- **Authorized official phone:** (877) 856-3774

## Contact information

- **Practice address:** 6610 WILLOW PARK DR STE 101, NAPLES, FL 34109-9014
- **Practice address phone:** (239) 649-3307
- **Practice address fax:** (239) 254-1782
- **Mailing address:** 2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
- **Mailing address phone:** (877) 856-3774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 09/24/2013
- **Last updated:** 01/18/2023