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MILLENNIUM PHYSICIAN GROUP LLC
NPI 1023780897
Family Medicine in Fort Myers, FL

Active since September 30, 2021CLIA Certified · 2 labs
9671 GLADIOLUS DR STE 109, FORT MYERS, FL 33908(239) 362-1450(239) 985-9629 Get Directions Write a Review

NPPES record last updated: January 18, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 18, 2023, Sep 30, 2021 (2 updates tracked since 2021).

About Millennium Physician Group Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MILLENNIUM PHYSICIAN GROUP LLC (NPI 1023780897) is a healthcare organization registered as a family medicine in Fort Myers, Florida and active in the NPI registry since September 2021. The organization holds 2 active CLIA laboratory certificates and lists Mary Haltigan, Director Of Revenue Cycle, as its authorized official.

NPPES Registry Identity

NPI1023780897
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMILLENNIUM PHYSICIAN GROUP LLC
Location Address9671 GLADIOLUS DR STE 109Fort Myers, FL 33908-7684
Mailing Address2675 Winkler Ave Fl 2Fort Myers, FL 33901-9342 · (877) 856-3774
Phone(239) 362-1450
Fax(239) 985-9629
Organization SubpartNo
Authorized OfficialMary HaltiganDirector Of Revenue Cycle · (877) 856-3774
Enumeration DateSeptember 30, 2021
Last NPPES UpdateJanuary 18, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 18, 2023
✔ NPI 1023780897 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
9671 GLADIOLUS DR STE 109, Fort Myers, FL 33908
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0972220

Millennium Physician Group, LLC · Fort Myers, FL
Active · expires Apr 2, 2028
CLIA Number10D0972220
Laboratory TypePhysician Office
Certificate Effective DateApril 3, 2026
Certificate Expiration DateApril 2, 2028
Laboratory DirectorDonald Harris
Laboratory Phone(941) 787-7665
Laboratory LocationMillennium Physician Group, LLC15661 San Carlos Blvd Ste 2, Fort Myers, FL 33908
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2333307

Millennium Physician Group LLC · Fort Myers, FL
Active · expires Nov 2, 2027
CLIA Number10D2333307
Laboratory TypePhysician Office
Certificate Effective DateNovember 3, 2025
Certificate Expiration DateNovember 2, 2027
Laboratory DirectorFrancesca Blazekovic
Laboratory Phone(941) 787-7665
Laboratory LocationMillennium Physician Group LLC17901 Summerlin Rd, Fort Myers, FL 33908
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEE HEALTH SYSTEM INC
General Practice
9671 GLADIOLUS DR STE 109
FORT MYERS, FL 33908
Lee County (239) 343-6788
TANNA R VAYON PA-C
Physician Assistant
9671 GLADIOLUS DR STE 109
FORT MYERS, FL 33908
Lee County (936) 230-4699
LEE HEALTH SYSTEM INC
General Practice
9671 GLADIOLUS DR STE 109
FORT MYERS, FL 33908
Lee County (239) 343-6788
KIMBERLY A BROWN-LUPIA PHD
Psychologist (Clinical Child & Adolescent)
9671 GLADIOLUS DR STE 109
FORT MYERS, FL 33908
Lee County (239) 343-6788

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Millennium Physician Group LLC's NPI number?

The NPI number for Millennium Physician Group LLC is 1023780897. It was assigned to this organization in the NPPES registry on September 30, 2021.

Where is Millennium Physician Group LLC located?

Millennium Physician Group LLC is located at 9671 Gladiolus Dr Ste 109, Fort Myers, FL 33908. The listed phone number is (239) 362-1450.

What is Millennium Physician Group LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Millennium Physician Group LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Millennium Physician Group LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Millennium Physician Group LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Millennium Physician Group LLC was last updated on January 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.