Provider Demographics
NPI:1912968694
Name:MILAM, CATHY P (MD)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:P
Last Name:MILAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-7006
Mailing Address - Country:US
Mailing Address - Phone:941-364-8220
Mailing Address - Fax:941-952-9503
Practice Address - Street 1:7400 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-7006
Practice Address - Country:US
Practice Address - Phone:941-364-8220
Practice Address - Fax:941-952-9503
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2008-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46768174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650472343OtherTAX-ID
FLE21822Medicare UPIN