# MILLENIUM MEDICAL GROUP CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Millenium Medical Group & CMHC Corp, Millenium Medical Group & CMHC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659049963
- **Authorized official:** MRS. DAMARYS SUAREZ QUIRIELLO (PRESIDENT)
- **Authorized official phone:** (786) 332-4330

## Contact information

- **Practice address:** 2720 SW 97TH AVE STE C105, MIAMI, FL 33165-2677
- **Practice address phone:** (786) 332-4330
- **Practice address fax:** (305) 381-0135
- **Mailing address:** 2720 SW 97TH AVE STE C105, MIAMI, FL 33165-2677
- **Mailing address phone:** (786) 332-4330
- **Mailing address fax:** (305) 381-0135

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/01/2021
- **Last updated:** 09/01/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 107892800 | — | FL |