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NPI Code Detail

MEDICARE: DR. ERNESTO J MILLAN M.D.

MEDICARE: DR. ERNESTO J MILLAN M.D.
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
12084N0402XNeurology with Special Qualifications in Child Neurology PhysicianME0079748FL

General Provider Information

NPI Number : 1083735856
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERNESTO J MILLAN M.D.
Provider Business Mailing Address
First Line : 5110 N HABANA AVE
Second Line : SUITE 1
City : TAMPA
State : FL
Zip : 33614-6873
Country : US
Telephone Number : 813-448-6755
Fax Number : 813-304-2219
Provider Business Practice Location Address
First Line : 5110 N. HABANA AVE.
Second Line : SUITE 1
City : TAMPA
State : FL
Zip : 33614-6873
Country : US
Telephone Number : 813-448-6755
Fax Number : 813-304-2219
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 04/08/2021

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