Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS6577 | FL |
N | 207U00000X | Nuclear Medicine Specialist | OS6577 | FL |
NPI | 1760484158 |
---|---|
Provider Name | Dr. Joseph C. Millin JR. |
First Address | Sarasota, FL 34239-2340 |
Second Address | Sarasota, FL 34239-2340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 20/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
080178578 | MEDICARE RR (01) | FL |
376919400 | (05) | FL |
80795 | BCBS (01) | FL |
F59187 | (02) | FL |