Provider Demographics
NPI:1639823503
Name:MILLENIUM CLINIC OF DADE INC
Entity Type:Organization
Organization Name:MILLENIUM CLINIC OF DADE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BATCHELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-487-0433
Mailing Address - Street 1:500 NW 165TH STREET RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6306
Mailing Address - Country:US
Mailing Address - Phone:178-665-7227
Mailing Address - Fax:
Practice Address - Street 1:500 NW 165TH STREET RD STE 203
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6348
Practice Address - Country:US
Practice Address - Phone:178-665-7227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health