Provider Demographics
NPI:1992362156
Name:MILANO, GUILLERMO CABUGAO JR (ATC,LAT)
Entity Type:Individual
Prefix:MR
First Name:GUILLERMO
Middle Name:CABUGAO
Last Name:MILANO
Suffix:JR
Gender:M
Credentials:ATC,LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8947 HAMPTON LANDING DR E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-4585
Mailing Address - Country:US
Mailing Address - Phone:904-400-1753
Mailing Address - Fax:
Practice Address - Street 1:10423 CENTURION PKWY N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-0527
Practice Address - Country:US
Practice Address - Phone:904-854-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL38332255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer