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Individual

DR. BEVERLY DENISE MCMILLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
10475 CENTURION PKWY N, SUITE 302, JACKSONVILLE, FL 32256-5003
(904) 398-5437
(904) 398-3077
Mailing address
1033 DR MARTIN LUTHER KING JR ST N, STE. 108, ST PETERSBURG, FL 33701-1547
(727) 456-4250
(727) 346-1044

Taxonomy

Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
ME36762
FL
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
ME36762
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0205114006
CIGNA
FL
05
068708100
FL
01
12056336
MULTI PLAN
FL
01
208957
AVMED
FL
01
4234338
AETNA
FL
01
53712
BC/BS OF FL
FL
01
728
MAYO
FL
01
P2759499
OXFORD
FL
Enumeration date
02/03/2006
Last updated
02/08/2010
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