Provider Demographics
NPI:1134186984
Name:JANICE E. MILLIGAN, MD PA
Entity type:Organization
Organization Name:JANICE E. MILLIGAN, MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MILLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-247-8585
Mailing Address - Street 1:125 NE 8TH ST
Mailing Address - Street 2:SUITE #4
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4676
Mailing Address - Country:US
Mailing Address - Phone:305-247-8585
Mailing Address - Fax:305-246-8109
Practice Address - Street 1:125 NE 8TH ST
Practice Address - Street 2:SUITE #4
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4676
Practice Address - Country:US
Practice Address - Phone:305-247-8585
Practice Address - Fax:305-246-8109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME31858207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58757Medicare UPIN
FL79362ZMedicare ID - Type Unspecified