Provider Demographics
NPI:1770860306
Name:IRINA MILMAN DO LLC
Entity Type:Organization
Organization Name:IRINA MILMAN DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-343-3994
Mailing Address - Street 1:968 HARBOR VW N
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-5059
Mailing Address - Country:US
Mailing Address - Phone:305-343-3994
Mailing Address - Fax:
Practice Address - Street 1:4050 SHERIDAN ST
Practice Address - Street 2:SUITE C
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3561
Practice Address - Country:US
Practice Address - Phone:954-889-0211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 9989207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty