MEDICARE: MILLENIA ADVANCED SCIENTIFIC 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	291U00000X	Clinical Medical Laboratory

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10D2197350	OTHER	FL	CLIA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346840485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLENIA ADVANCED SCIENTIFIC LLC

Provider Business Mailing Address
First Line	:	4303 VINELAND RD STE F7
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-7372
Country	:	US
Telephone Number	:	407-429-5088
Fax Number	:	407-429-5059

Provider Business Practice Location Address
First Line	:	4303 VINELAND RD STE F7
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-7372
Country	:	US
Telephone Number	:	407-429-5088
Fax Number	:	407-429-5059

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. NATHANIEL JOSH KAHN
Credential	:
Telephone Number	:	407-429-5088

Provider Enumeration Date	:	10/28/2020
Last Update Date	:	01/23/2026

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