Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | ME0079748 | FL |
NPI | 1083735856 |
---|---|
Provider Name | Dr. Ernesto J Millan |
First Address | Tampa, FL 33614-6873 |
Second Address | Tampa, FL 33614-6873 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 08/04/2021 |