MEDICARE: MILAN MITROVIC LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MT4859	FL

General Provider Information

NPI Number	:	1912766775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILAN MITROVIC LMFT

Provider Business Mailing Address
First Line	:	9995 GATE PKWY N STE 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-0800
Country	:	US
Telephone Number	:	833-769-3524
Fax Number	:	706-410-1490

Provider Business Practice Location Address
First Line	:	9995 GATE PKWY N STE 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-0800
Country	:	US
Telephone Number	:	833-769-3524
Fax Number	:	706-410-1490

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2024
Last Update Date	:	08/28/2025

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Directions to “ MILAN MITROVIC LMFT” Practice Location

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