MILLENNIUM PHYSICIAN GROUP LLC (NPI# 1073131702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073131702 |
| Entity Type | Organization |
| Organization Name | MILLENNIUM PHYSICIAN GROUP LLC |
| Practice Address |
31075 Cortez Blvd Brooksville FL 34602-7542 |
| Mailing Address |
2675 Winkler Ave Fl 2 Fort Myers FL 33901-9342 |
| Practice Telephone | 3527965303 |
| Practice Fax Number | 3527965304 |
| Mailing Telephone | 8778563774 |
| Mailing Fax Number | 2395992612 |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-09 |
| Authorized Official Name | JOANNE SHERMAN (BUSINESS SERVICES SUPERVISOR) |
| Authorized Official Telephone | 8778563774 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497181341 | Millennium Physician Group LLC | Durable Medical Equipment & Medical Supplies | 6610 Willow Park Dr Ste 101, Naples, FL 34109-9014 | 2013-09-24 |
| 1811122880 | Millennium Physician Group LLC | Internal Medicine | 6321 Daniels Pkwy, Fort Myers, FL 33912-4773 | 2009-05-20 |
| 1316319221 | Millennium Physician Group LLC | Durable Medical Equipment & Medical Supplies | 9400 Bonita Beach Rd Se, Ste. 101, Bonita Springs, FL 34135-4520 | 2015-10-30 |
| 1023444874 | Millennium Physician Group LLC | Durable Medical Equipment & Medical Supplies | 400 8th St N, Naples, FL 34102-5519 | 2013-09-24 |
| 1457787202 | Millennium Physician Group LLC | Durable Medical Equipment & Medical Supplies | 2450 Tamiami Trl Ste A, Port Charlotte, FL 33952-3922 | 2013-09-24 |
| 1538509278 | Millennium Physician Group LLC | Pharmacy | 19531 Cochran Blvd, Port Charlotte, FL 33948-2081 | 2013-06-26 |
| 1275971764 | Millennium Physician Group LLC | Internal Medicine | 6321 Daniels Pkwy, Ste 201, Fort Myers, FL 33912-4773 | 2013-06-06 |
| Street Address |
31075 CORTEZ BLVD |
| City | BROOKSVILLE |
| State | FL |
| Zip Code | 34602-7542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669580668 | Mark D Bowden | Family Medicine | 31075 Cortez Blvd, Brooksville, FL 34602-7542 | 2006-08-29 |
| 1356796601 | Kellen H Gower | Family Medicine | 31075 Cortez Blvd, Brooksville, FL 34602-7542 | 2016-04-24 |
| 1447691456 | Sharon Ann Powers | Nurse Practitioner | 31075 Cortez Blvd, Brooksville, FL 34602-7542 | 2013-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669975868 | Tachara Stanton | Behavioral Analyst | 30958 Water Lily Dr, Brooksville, FL 34602 | 2018-03-14 |
| 1629290721 | Leslie Foster Home | Custodial Care Facility | 4063 Baseball Pond Road, Brooksville, FL 34602 | 2007-05-02 |
| 1255343901 | Guillermo Mantilla Cadena | Psychiatry & Neurology | 22770 Skyview Cir, Brooksville, FL 34602-3106 | 2006-08-12 |
| 1407218092 | Foundations Foot and Ankle LLC | Podiatrist | 22319 Powell Rd, Brooksville, FL 34602-5705 | 2016-03-23 |
| 1699807982 | Thomas S. Hogan Sr. | Pharmacist | 22331 Powell Rd, Brooksville, FL 34602-5705 | 2007-03-12 |
| 1720634645 | Cassandrea Marie Bloxsom-joiner | Behavior Technician | 1211 Culbreath Rd, Brooksville, FL 34602-6003 | 2019-08-15 |
| 1114431194 | Beket Lott | Counselor | 201 Culbreath Rd, Brooksville, FL 34602-6017 | 2017-11-28 |
| 1194891929 | Eckerd Youth Alternatives Inc | Psychiatric Residential Treatment Facility | 201 Culbreath Rd, Brooksville, FL 34602-6017 | 2006-11-24 |
| 1982773024 | Eckerd Youth Alternatives Inc | Psychiatric Residential Treatment Facility | 397 Culbreath Rd, Brooksville, FL 34602-6019 | 2006-11-06 |
| 1073129136 | Karen Harris | Nurse Practitioner | 28211 Church Rd, Brooksville, FL 34602-6232 | 2020-09-23 |
| Find all providers in zip 34602 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407405822 | Medical Risk Solutions | Family Medicine | 12080 Cortez Blvd, Brooksville, FL 34613 | 2019-09-09 |
| 1316196744 | Osteopathic Heritage, P.a. | Family Medicine | 959 W Jefferson St, Brooksville, FL 34601-2427 | 2008-09-10 |
| 1942335104 | Brooksville Walk In Clinic LLC | Family Medicine | 433 W Jefferson St, Brooksville, FL 34601-2500 | 2007-02-21 |
| 1669580668 | Mark D Bowden | Family Medicine | 31075 Cortez Blvd, Brooksville, FL 34602-7542 | 2006-08-29 |
| 1013025022 | Ridge Manor Family Medicine,llc | Family Medicine | 31158 Cortez Blvd, Brooksville, FL 34602-7552 | 2006-08-29 |
| 1417963778 | Mauricio Bermudez | Family Medicine | 12900 Cortez Blvd Ste 102, Brooksville, FL 34613-6897 | 2006-07-31 |
| 1164456059 | Brian M Roebuck | Family Medicine | 11329 Cortez Blvd, Brooksville, FL 34613-5407 | 2006-07-10 |
| 1134152044 | Jatin Natvarlal Sheth | Family Medicine | 920 W Jefferson St, Brooksville, FL 34601-2428 | 2006-07-07 |
| 1578591095 | Michael Rhea King | Family Medicine | 44 Veterans Ave, Brooksville, FL 34601-3215 | 2006-06-30 |
| 1033169487 | Manjari Ilesh Patel | Family Medicine | 11375 Cortez Blvd., State Rd 50, Oak Hill Hospital, Brooksville, FL 34613 | 2006-05-10 |
| Find all providers in BROOKSVILLE | ||||
| City | BROOKSVILLE |
| Zip Code | 34602 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.