Healthcare Provider Details

I. General information

NPI: 1427973205
Provider Name (Legal Business Name): JUAN MILAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3216 NW 2ND PL
CAPE CORAL FL
33993-6517
US

IV. Provider business mailing address

3216 NW 2ND PL
CAPE CORAL FL
33993-6517
US

V. Phone/Fax

Practice location:
  • Phone: 239-785-5882
  • Fax:
Mailing address:
  • Phone: 239-785-5882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: