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MILLENNIUM PHYSICIAN GROUP LLC
NPI 1063184711
Family Medicine in N Fort Myers, FL

Active since October 01, 2021CLIA 10D2132690 · Waiver
3434 HANCOCK BRIDGE PKWY STE 309, N FORT MYERS, FL 33903(855) 674-8800(239) 599-4126 Get Directions Write a Review

NPPES record last updated: January 18, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 18, 2023, Oct 1, 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 1063184711) is a healthcare organization registered as a family medicine in N Fort Myers, Florida and active in the NPI registry since October 2021. The organization holds a CLIA Waiver certificate valid through June 26, 2027 and lists Mary Haltigan, Director Of Revenue Cycle, as its authorized official.

NPPES Registry Identity

NPI1063184711
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMILLENNIUM PHYSICIAN GROUP LLC
Location Address3434 HANCOCK BRIDGE PKWY STE 309N Fort Myers, FL 33903-7099
Mailing Address2675 Winkler Ave Fl 2Fort Myers, FL 33901-9342 · (877) 856-3774
Phone(855) 674-8800
Fax(239) 599-4126
Organization SubpartNo
Authorized OfficialMary HaltiganDirector Of Revenue Cycle · (877) 856-3774
Enumeration DateOctober 1, 2021
Last NPPES UpdateJanuary 18, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 18, 2023
✔ NPI 1063184711 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.
3434 HANCOCK BRIDGE PKWY STE 309, N Fort Myers, FL 33903
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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

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 10D2132690

Millennium Physician Group - Home Visit · N Ft Myers, FL
Active · expires Jun 26, 2027
CLIA Number10D2132690
Laboratory TypePhysician Office
Certificate Effective DateJune 27, 2025
Certificate Expiration DateJune 26, 2027
Laboratory DirectorRick Waks
Laboratory Phone(833) 674-2500
Laboratory LocationMillennium Physician Group - Home Visit15201 N Cleveland Ave Suite 1010, N Ft Myers, FL 33903
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

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

TIMOTHY PINETREE LARSEN DNP
Nurse Practitioner (Adult Health)
3434 HANCOCK BRIDGE PKWY STE 309
NORTH FORT MYERS, FL 33903
Lee County (855) 674-8800

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 1063184711. It was assigned to this organization in the NPPES registry on October 1, 2021.

Where is Millennium Physician Group LLC located?

Millennium Physician Group LLC is located at 3434 Hancock Bridge Pkwy Ste 309, N Fort Myers, FL 33903. The listed phone number is (855) 674-8800.

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 a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2132690) is associated with this NPI, valid through June 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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.