Provider Demographics
NPI:1730291451
Name:MUIR, MILLICENT (MD)
Entity Type:Individual
Prefix:DR
First Name:MILLICENT
Middle Name:
Last Name:MUIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:MILLICENT
Other - Middle Name:
Other - Last Name:ROWE-BOYD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2665 EXECUTIVE PARK DR
Mailing Address - Street 2:STE 1
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3652
Mailing Address - Country:US
Mailing Address - Phone:305-761-6451
Mailing Address - Fax:954-239-3902
Practice Address - Street 1:2665 EXECUTIVE PARK DR
Practice Address - Street 2:STE 1
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3652
Practice Address - Country:US
Practice Address - Phone:305-761-6451
Practice Address - Fax:954-239-3902
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94911207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8690437789Medicaid