Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Millennium Physician Group LLC

Organization Family Medicine Physician · NPI 1417610403

Millennium Physician Group LLC is a Family Medicine Physician in Tampa, Florida. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

15416 N Florida Ave
Tampa, FL 33613-1244
Phone: (813) 723-5450
Fax: (813) 723-5451
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1417610403
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Haltigan — Director Of Revenue Cycle · (877) 856-3774
NPI enumeratedOctober 18, 2021
Last updated in NPPESJanuary 18, 2023
Certification dateJanuary 18, 2023
Mailing address2675 Winkler Ave Fl 2, Fort Myers, FL 33901-9342

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