Provider Demographics
NPI:1083735856
Name:MILLAN, ERNESTO J (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNESTO
Middle Name:J
Last Name:MILLAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5110 N HABANA AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-6873
Mailing Address - Country:US
Mailing Address - Phone:813-448-6755
Mailing Address - Fax:813-304-2219
Practice Address - Street 1:5110 N. HABANA AVE.
Practice Address - Street 2:SUITE 1
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-6873
Practice Address - Country:US
Practice Address - Phone:813-448-6755
Practice Address - Fax:813-304-2219
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2021-04-08
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Provider Licenses
StateLicense IDTaxonomies
FLME00797482084N0402X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology