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General NPI Number Information
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NPI Number | 1992362156
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Entity Type | Individual
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Provider Name | GUILLERMO CABUGAO MILANO JR. ATC,LAT
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Gender | Male
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 05/23/2019
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Provider Practice Location Address
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Address Line | 10423 CENTURION PKWY N
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City | JACKSONVILLE
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State | FL
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Zip | 32256-0527
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Country | US
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Telephone | 904-854-2090
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Fax |
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Provider Business Mailing Address
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Address Line | 8947 HAMPTON LANDING DR E
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City | JACKSONVILLE
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State | FL
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Zip | 32256-4585
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Country | US
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Telephone | 904-400-1753
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL3833
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License Number State | FL
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