MILLENIUM MEDICAL MANAGEMENT LLC (NPI# 1366645376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366645376 |
| Entity Type | Organization |
| Organization Name | MILLENIUM MEDICAL MANAGEMENT LLC |
| Other Organization Name | DEUK SPINE INSTITUTE-VIERA ORTHOPEDIC-VIERA HEALTH AND WELLNESS |
| Practice Address |
836 Century Medical Dr Titusville FL 32796-2141 |
| Mailing Address |
7955 Spyglass Hill Rd Ste A Melbourne FL 32940-8249 |
| Practice Telephone | 3213838092 |
| Practice Fax Number | 3213831043 |
| Mailing Telephone | 3212556670 |
| Mailing Fax Number | 3212422545 |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2015-03-31 |
| Authorized Official Name | SUN MEE DEUKMEDJIAN (FINANCIAL OFFICER) |
| Authorized Official Telephone | 3217751290 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
ME93866 | FL | Allopathic & Osteopathic Physicians |
| N | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
IAC ACCREDITED 7 | FL | Ambulatory Health Care Facilities |
| N | 208100000X | Physical Medicine & Rehabilitation | ME93866 | FL | Allopathic & Osteopathic Physicians |
| N | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
ME93866 | FL | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
ME111580 | FL | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
ME93866 | FL | Allopathic & Osteopathic Physicians |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9105911 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 207Q00000X | Family Medicine | ME84856 | FL | Allopathic & Osteopathic Physicians |
| N | 208100000X | Physical Medicine & Rehabilitation | ME111580 | FL | Allopathic & Osteopathic Physicians |
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
ME111580 | FL | Allopathic & Osteopathic Physicians |
| N | 208100000X | Physical Medicine & Rehabilitation | OS12589 | FL | Allopathic & Osteopathic Physicians |
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
OS12589 | FL | Allopathic & Osteopathic Physicians |
| Y | 207T00000X | Neurological Surgery | ME82061 | FL | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | ME95180 | FL | Allopathic & Osteopathic Physicians |
| N | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
ME95180 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | CIGNA | 2921108 | 01 |
| FL | AETNA | 3612958 | 01 |
| FL | DOL ASC | 613998300 | 01 |
| FL | BCBSFL | 33435 | 01 |
| FL | MEDICARE RAILROAD CARRIER | DG6510 | 01 |
| Other Name | Type Code |
|---|---|
| Deuk Spine Institute-Viera Orthopedic-Viera Health and Wellness | Doing Business As Name - Organization |
| Street Address |
836 CENTURY MEDICAL DR |
| City | TITUSVILLE |
| State | FL |
| Zip Code | 32796-2141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457351322 | Bharat C Patel | Physical Medicine & Rehabilitation | 836 Century Medical Dr, Titusville, FL 32796-2141 | 2005-07-21 |
| 1093953838 | Augusto Jorge Cianciabella | Physician Assistant | 836 Century Medical Dr, Titusville, FL 32796-2141 | 2009-02-02 |
| 1245432459 | Ajmal Aziz Sultan | Physical Medicine & Rehabilitation | 836 Century Medical Dr, Titusville, FL 32796-2141 | 2007-06-01 |
| 1619079662 | Ara Jason Deukmedjian | Neurological Surgery | 836 Century Medical Dr, Titusville, FL 32796-2141 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427698091 | Miranda Jade Lacey | Behavior Technician | 2073 Graden St, Titusville, FL 32796 | 2020-01-13 |
| 1588183818 | Charles Hopkins Jr. | Behavior Technician | 2073 Garden St., Titusville, FL 32796 | 2017-09-19 |
| 1962924456 | Robin Marie Ahlgren | Social Worker | 503 South Palm Ave, Titusville, FL 32796 | 2017-07-17 |
| 1669994158 | New Creation Counseling | Social Worker | 503 South Palm Ave., Titusville, FL 32796 | 2017-07-17 |
| 1255719506 | Daniel Joseph Spagnoli | Dentist | 55 N Carpenter Rd, Titusville, FL 32796 | 2015-05-07 |
| 1033511415 | Imran Rashid Md Pa | Internal Medicine | 3300 Dairy Road, Titusville, FL 32796 | 2014-09-17 |
| 1639425432 | William Henry Ruppert Jr. | Dietitian, Registered | 2191 Garden Street, Titusville, FL 32796 | 2012-07-30 |
| 1437410230 | Betsy Cooduvalli | Dermatology | 500 N Washington Ave Ste 109, Titusville, FL 32796 | 2012-06-07 |
| 1134403108 | Titusville Chiropractic & Injury Center, Inc. | Chiropractor | 850 Century Medical Drive, Titusville, FL 32796 | 2011-10-07 |
| 1992095152 | Jennifer Eleanor Koffman | Occupational Therapy Assistant | 140 N Hilltop Drive, Titusville, FL 32796 | 2011-04-08 |
| Find all providers in zip 32796 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619079662 | Ara Jason Deukmedjian | Neurological Surgery | 836 Century Medical Dr, Titusville, FL 32796-2141 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063032514 | Jose Valerio Md Pllc | Neurological Surgery | 2741 Executive Park Dr Ste 2, Weston, FL 33331-3641 | 2020-04-24 |
| 1376172478 | Neuspine Ancillary LLC | Neurological Surgery | 510 Vonderburg Dr Ste 213, Brandon, FL 33511-5981 | 2020-04-02 |
| 1013542364 | Michelle Carnes | Neurological Surgery | 2575 Northbrooke Plaza Dr Unit 100, Naples, FL 34119-8105 | 2020-03-06 |
| 1962049163 | East Coast Neuro Spine Clinic, LLC | Neurological Surgery | 1601 S Apollo Blvd Ste C, Melbourne, FL 32901-4484 | 2019-12-06 |
| 1659913796 | Orlando Neurosurgical Solutions LLC | Neurological Surgery | 2706 Rew Cir # 205, Ocoee, FL 34761-4215 | 2019-10-10 |
| 1760047831 | North Broward Neurospinal Surgery Inc | Neurological Surgery | 1 W Sample Rd Ste 209, Pompano Beach, FL 33064-3547 | 2019-05-04 |
| 1932672912 | Volusia Neurosurgical Associates | Neurological Surgery | 311 N Clyde Morris Blvd Ste 440, Daytona Beach, FL 32114-2757 | 2019-01-02 |
| 1861961344 | Expert Neurosurgical Services LLC | Neurological Surgery | 600 Heritage Dr Ste 105, Jupiter, FL 33458-3098 | 2018-11-14 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1114492493 | Lloyd Maliner, Md Pa | Neurological Surgery | 301 Nw 84th Ave Ste 206, Plantation, FL 33324-1807 | 2018-10-12 |
| Find all providers with the same taxonomy | ||||
| City | TITUSVILLE |
| Zip Code | 32796 |
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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.