MEDICARE: MILLENNIUM AESTHETICS

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1306720958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLENNIUM AESTHETICS

Provider Business Mailing Address
First Line	:	1324 SE 17TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-1708
Country	:	US
Telephone Number	:	954-998-3527
Fax Number	:

Provider Business Practice Location Address
First Line	:	1324 SE 17TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-1708
Country	:	US
Telephone Number	:	954-998-3527
Fax Number	:

Authorized Official
Title or Position	:	GENERAL DENTIST
Name	:	ERIC SCHUETZ
Credential	:	DMD
Telephone Number	:	954-998-3527

Provider Enumeration Date	:	08/05/2025
Last Update Date	:	08/06/2025

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