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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