Provider Demographics
NPI:1164569604
Name:MILLENIUM MEDICAL EMERGENCY GROUP
Entity Type:Organization
Organization Name:MILLENIUM MEDICAL EMERGENCY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:F
Authorized Official - Last Name:CAMPOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-745-0708
Mailing Address - Street 1:PMB 171 BOX 4956
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-0000
Mailing Address - Country:US
Mailing Address - Phone:787-745-0708
Mailing Address - Fax:787-745-0708
Practice Address - Street 1:HOSPITAL SAN JUAN BAUTISTA
Practice Address - Street 2:URB TURABO GARDENS CARR 172
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0000
Practice Address - Country:US
Practice Address - Phone:787-653-0550
Practice Address - Fax:787-745-0708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12308261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care