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

Millennium Physician Group LLC

Organization Family Medicine Physician · NPI 1417629106

Millennium Physician Group LLC is a Family Medicine Physician in Jacksonville Beach, 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

1351 13th Ave S Ste 110
Jacksonville Beach, FL 32250-3237
Phone: (904) 249-9995
Fax: (904) 249-9449
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1417629106
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Haltigan — Director Of Revenue Cycle · (877) 856-3774
NPI enumeratedSeptember 30, 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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