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MILLENNIUM PHYSICIAN GROUP, LLC
NPI 1063185601
Family Medicine in Cape Coral, FL

Active since July 29, 2021CLIA Certified · 3 labs
2002 DEL PRADO BLVD S STE 100, CAPE CORAL, FL 33990(239) 217-4470(239) 217-4474 Get Directions Write a Review

NPPES record last updated: January 18, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 18, 2023, Jul 29, 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 1063185601) is a healthcare organization registered as a family medicine in Cape Coral, Florida and active in the NPI registry since July 2021. The organization holds 3 active CLIA laboratory certificates and lists Mary Haltigan, Director Revenue Cycle, as its authorized official.

NPPES Registry Identity

NPI1063185601
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMILLENNIUM PHYSICIAN GROUP, LLC
Location Address2002 DEL PRADO BLVD S STE 100Cape Coral, FL 33990-4557
Mailing Address2675 Winkler Ave Fl 2Fort Myers, FL 33901-9342 · (877) 856-3774
Phone(239) 217-4470
Fax(239) 217-4474
Organization SubpartNo
Authorized OfficialMary HaltiganDirector Revenue Cycle · (877) 856-3774
Enumeration DateJuly 29, 2021
Last NPPES UpdateJanuary 18, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 18, 2023
✔ NPI 1063185601 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.
2002 DEL PRADO BLVD S STE 100, Cape Coral, FL 33990
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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 3

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 10D0942849

Millennium Physician Group, LLC · Cape Coral, FL
Active · expires Mar 17, 2028
CLIA Number10D0942849
Laboratory TypePhysician Office
Certificate Effective DateMarch 18, 2026
Certificate Expiration DateMarch 17, 2028
Laboratory DirectorSarada Penukonda
Laboratory Phone(941) 787-7665
Laboratory LocationMillennium Physician Group, LLC323 Del Prado Blvd Suite 100, Cape Coral, FL 33990
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2054937

Millennium Physician Group, LLC · Cape Coral, FL
Active · expires Feb 28, 2027
CLIA Number10D2054937
Laboratory TypePhysician Office
Certificate Effective DateMarch 1, 2025
Certificate Expiration DateFebruary 28, 2027
Laboratory DirectorJerry Lanza
Laboratory Phone(941) 787-7665
Laboratory LocationMillennium Physician Group, LLC2002 Del Prado Blvd - Ste 100, Cape Coral, FL 33990
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D0918382

Millennium Physician Group · Cape Coral, FL
Active · expires Aug 6, 2026
CLIA Number10D0918382
Laboratory TypePhysician Office
Certificate Effective DateAugust 7, 2024
Certificate Expiration DateAugust 6, 2026
Laboratory DirectorGeorge M. Mestas MD
Laboratory Phone(941) 764-1880
Laboratory LocationMillennium Physician Group1528 Del Prado Blvd, Cape Coral, FL 33990
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 2

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

XTREME CARE REHABILITATION CENTER INC
Chiropractor
2002 DEL PRADO BLVD S STE 100
CAPE CORAL, FL 33990
Lee County (239) 424-8442
DIVERSE HEALTHCARE INITIATIVES FOR ECOLOGY, EPIDEMIOLOGY & EDUCATION
Clinic/Center (Primary Care)
2002 DEL PRADO BLVD S STE 100
CAPE CORAL, FL 33990
Lee County (239) 248-9257

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 1063185601. It was assigned to this organization in the NPPES registry on July 29, 2021.

Where is Millennium Physician Group, LLC located?

Millennium Physician Group, LLC is located at 2002 Del Prado Blvd S Ste 100, Cape Coral, FL 33990. The listed phone number is (239) 217-4470.

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. 3 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 with the weekly NPPES data releases published by CMS.