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NPI Code Detail

MEDICARE: DEREK MILLIGAN

MEDICARE: DEREK MILLIGAN
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
1103K00000XBehavior Analyst1-14-10252FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164842654
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEREK MILLIGAN
Provider Business Mailing Address
First Line : 453 KING ST
Second Line :
City : COCOA
State : FL
Zip : 32922-7621
Country : US
Telephone Number : 321-633-5511
Fax Number : 212-087-4413
Provider Business Practice Location Address
First Line : 453 KING ST
Second Line :
City : COCOA
State : FL
Zip : 32922-7621
Country : US
Telephone Number : 321-633-5511
Fax Number : 212-087-4413
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2014
Last Update Date : 03/10/2022

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Directions to “ DEREK MILLIGAN ” Practice Location

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