Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | ME36762 | FL |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME36762 | FL |
NPI | 1134191034 |
---|---|
Provider Name | Dr. Beverly Denise Mcmillin |
First Address | St Petersburg, FL 33701-1547 |
Second Address | Jacksonville, FL 32256-5003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 08/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0205114006 | CIGNA (01) | FL |
068708100 | (05) | FL |
12056336 | MULTI PLAN (01) | FL |
208957 | AVMED (01) | FL |
4234338 | AETNA (01) | FL |
53712 | BC/BS OF FL (01) | FL |
728 | MAYO (01) | FL |
D86024 | (02) | |
P2759499 | OXFORD (01) | FL |