Provider Demographics
NPI:1760484158
Name:MILLIN, JOSEPH C JR (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:MILLIN
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1219 S EAST AVE
Mailing Address - Street 2:208
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 S EAST AVE
Practice Address - Street 2:SUITE 208
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
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6577207Q00000X, 207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376919400Medicaid
FL080178578OtherMEDICARE RR
FL80795OtherBCBS
FL80795VMedicare PIN
FL080178578OtherMEDICARE RR