Provider Demographics
NPI:1164709952
Name:MILLENNIUM HEALTH SOLUTIONS, INC.
Entity Type:Organization
Organization Name:MILLENNIUM HEALTH SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GLOER
Authorized Official - Suffix:
Authorized Official - Credentials:BS, RN
Authorized Official - Phone:727-541-2675
Mailing Address - Street 1:10460 ROOSEVELT BLVD. N
Mailing Address - Street 2:SUITE 291
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716
Mailing Address - Country:US
Mailing Address - Phone:727-541-2675
Mailing Address - Fax:727-541-3956
Practice Address - Street 1:10460 ROOSEVELT BLVD N
Practice Address - Street 2:SUITE 291
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-3821
Practice Address - Country:US
Practice Address - Phone:727-541-2675
Practice Address - Fax:727-541-3956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty