Provider Demographics
NPI:1164486957
Name:DR ADOLFO N MILLAN PA
Entity Type:Organization
Organization Name:DR ADOLFO N MILLAN PA
Other - Org Name:SOUTH FLORIDA INSTITUTE OF NEUROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADOLFO
Authorized Official - Middle Name:NAVARRO
Authorized Official - Last Name:MILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-478-7422
Mailing Address - Street 1:5601 CORPORATE WAY
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407
Mailing Address - Country:US
Mailing Address - Phone:561-478-7422
Mailing Address - Fax:561-478-2377
Practice Address - Street 1:5601 CORPORATE WAY
Practice Address - Street 2:SUITE 206
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407
Practice Address - Country:US
Practice Address - Phone:561-478-7422
Practice Address - Fax:561-478-2377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0026226174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263374400Medicaid
FL263374400Medicaid