MEDICARE: DR. JOSEPH C. MILLIN JR. D.O.

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	OS6577	FL
2	207U00000X	Nuclear Medicine Physician	OS6577	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080178578	OTHER	FL	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	80795	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1760484158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH C. MILLIN JR. D.O.

Provider Business Mailing Address
First Line	:	1219 S EAST AVE
Second Line	:	208
City	:	SARASOTA
State	:	FL
Zip	:	34239-2340
Country	:	US
Telephone Number	:	941-363-9444
Fax Number	:	941-363-9349

Provider Business Practice Location Address
First Line	:	1219 S EAST AVE
Second Line	:	SUITE 208
City	:	SARASOTA
State	:	FL
Zip	:	34239-2340
Country	:	US
Telephone Number	:	941-363-9444
Fax Number	:	941-363-9349

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	03/20/2014

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Directions to “ DR. JOSEPH C. MILLIN JR. D.O.” Practice Location

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