Provider Demographics
NPI:1407811813
Name:JOSEPH C MILLIN JR DO PA
Entity Type:Organization
Organization Name:JOSEPH C MILLIN JR DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:MILLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:941-363-9444
Mailing Address - Street 1:1219 EAST AVE SO
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2340
Mailing Address - Country:US
Mailing Address - Phone:941-363-9444
Mailing Address - Fax:941-363-9349
Practice Address - Street 1:1219 EAST AVE SO
Practice Address - Street 2:SUITE208
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2340
Practice Address - Country:US
Practice Address - Phone:941-363-9444
Practice Address - Fax:941-363-9349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCJ4517OtherRR MEDICARE
FL000228800Medicaid
FL40911OtherBCBS
FL40911OtherBCBS
FLAK568Medicare PIN