Individual
POLLYNESIA MCMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2209 E 113TH AVE, TAMPA, FL 33612-6248
(813) 490-5490
Mailing address
2209 E 113TH AVE, TAMPA, FL 33612-6248
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/23/2013
Last updated
08/23/2013
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