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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 OF REVENUE CYCLE)
(877) 856-3774
Entity
Organization
Contact information
Practice address
1340 S 18TH ST STE 204, FERNANDINA BEACH, FL 32034-4733
(904) 261-0643
(941) 277-4082
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
(239) 599-2612
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/30/2021
Last updated
01/19/2023
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