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NPI Code Detail

MEDICARE: ERNESTO J. MILLAN MD. PA.

MEDICARE: ERNESTO J. MILLAN MD. PA.
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 Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851638167
Entity Type Code : Organization
Provider Name (Legal Business Name) : ERNESTO J. MILLAN MD. PA.
Provider Business Mailing Address
First Line : 5110 N. HABANA AVE. SUITE #1
Second Line :
City : TAMPA
State : FL
Zip : 33614-6873
Country : US
Telephone Number : 813-448-6755
Fax Number :
Provider Business Practice Location Address
First Line : 5110 N. HABANA AVE. SUITE #1
Second Line :
City : TAMPA
State : FL
Zip : 33614-6873
Country : US
Telephone Number : 813-448-6755
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. ERNESTO JOSE MILLAN
Credential : M.D.
Telephone Number : 813-448-6755
Provider Enumeration Date : 01/07/2013
Last Update Date : 04/08/2021

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