Provider Demographics
NPI:1851708630
Name:MILLENNIUM HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:MILLENNIUM HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BENTVENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-433-8500
Mailing Address - Street 1:4949 S CONGRESS AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-4731
Mailing Address - Country:US
Mailing Address - Phone:561-433-8500
Mailing Address - Fax:561-601-1290
Practice Address - Street 1:4949 S CONGRESS AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4731
Practice Address - Country:US
Practice Address - Phone:561-433-8500
Practice Address - Fax:561-601-1290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL800027244291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory