MEDICARE: MILLENNIUM PHYSICIAN GROUP LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1013670090
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLENNIUM PHYSICIAN GROUP LLC

Provider Business Mailing Address
First Line	:	2675 WINKLER AVE FL 2
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9342
Country	:	US
Telephone Number	:	877-856-3774
Fax Number	:	239-599-2612

Provider Business Practice Location Address
First Line	:	800 GOODLETTE ROAD N
Second Line	:	SUITE 200
City	:	NAPLES
State	:	FL
Zip	:	34102-5408
Country	:	US
Telephone Number	:	239-302-3300
Fax Number	:	239-302-3301

Authorized Official
Title or Position	:	DIRECTOR OF REVENUE CYCLE
Name	:	MARY HALTIGAN
Credential	:
Telephone Number	:	877-856-3774

Provider Enumeration Date	:	10/18/2021
Last Update Date	:	01/18/2023

Similar Medicare Providers

1497758833 — DR. SUSAN BEST DO
Practice Location Address:

800 GOODLETTE RD STE 205
NAPLES, FL
34102-5408

Practice Phone: 239-315-7538
Practice Fax: 239-315-7539

1255384749 — DR. KAE L FERBER MD
Practice Location Address:

800 GOODLETTE RD STE 200
NAPLES, FL
34102-5408

Practice Phone: 239-263-8222
Practice Fax: 239-263-8788

1740469030 — CORY DWAYNE LAMAR M.D.
Practice Location Address:

800 GOODLETTE-FRANK RD N STE 205
NAPLES, FL
34102-5408

Practice Phone: 239-667-5878
Practice Fax: 238-667-5838

1003096587 — DR. MANRIQUE OSCAR IRIARTE M.D.
Practice Location Address:

800 GOODLETTE RD STE 200
NAPLES, FL
34102-5408

Practice Phone: 239-302-3300
Practice Fax:

1639832520 — MILLENNIUM PHYSICIAN GROUP LLC
Practice Location Address:

800 GOODLETTE RD STE 205
NAPLES, FL
34102-5408

Practice Phone: 239-315-7538
Practice Fax: 239-315-7539

1861347940 — JUAN FERNANDEZ MEDEROS
Practice Location Address:

670 GOODLETTE-FRANK RD N
NAPLES, FL
34102-5614

Practice Phone: 232-316-7656
Practice Fax:

Directions to “MILLENNIUM PHYSICIAN GROUP LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.