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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 MNGMT)
(877) 856-3774
Entity
Organization
Contact information
Practice address
6321 DANIELS PKWY, FORT MYERS, FL 33912-4773
(877) 856-3774
(239) 599-2612
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
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Enumeration date
05/20/2009
Last updated
02/23/2024
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