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Organization
MILLENIUM MEDICAL GROUP CORP.
Active
Organization
MILLENIUM MEDICAL GROUP CORP.
Active
Other names
Millenium Medical group
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAMARYS SUAREZ (ADMINISTRATOR)
(305) 613-0798
Entity
Organization
Contact information
Practice address
2740 SW 97TH AVE, SUITE NUMBER A-111, MIAMI, FL 33165-3316
(786) 332-4330
(786) 332-4109
Mailing address
2740 SW 97TH AVE STE A-111, MIAMI, FL 33165-2681
(786) 332-4330
(786) 332-4109
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
ARNP9227984
FL
225700000X
Massage Therapist
MA64254
FL
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
01/08/2018
Last updated
09/09/2021
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