Provider Demographics
NPI:1720091853
Name:MILLAND, ENID (MD)
Entity Type:Individual
Prefix:
First Name:ENID
Middle Name:
Last Name:MILLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ENID
Other - Middle Name:
Other - Last Name:MILLAND VIGIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5130 SUNFOREST DR STE 300
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-6327
Mailing Address - Country:US
Mailing Address - Phone:727-824-0780
Mailing Address - Fax:813-514-8891
Practice Address - Street 1:461 W OAK ST STE A
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-6624
Practice Address - Country:US
Practice Address - Phone:078-468-6004
Practice Address - Fax:407-846-2301
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91653207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLLX436OtherMEDICARE
FLME91653OtherMEDICAL LICENSE