Provider Demographics
NPI:1083821045
Name:MILLEN, JOSEPH DANIEL (PT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:DANIEL
Last Name:MILLEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 WESTON TER
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-1313
Mailing Address - Country:US
Mailing Address - Phone:727-785-8737
Mailing Address - Fax:727-786-8546
Practice Address - Street 1:180 ALT 19
Practice Address - Street 2:SUITE B
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-5308
Practice Address - Country:US
Practice Address - Phone:727-785-8737
Practice Address - Fax:727-786-8546
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 5540225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist