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MILLENNIUM PHYSICIAN GROUP LLC
NPI 1336811082
Family Medicine in Punta Gorda, FL

Active since October 01, 2021CLIA 10D2104406 · Waiver
150 W MCKENZIE ST STE 112, PUNTA GORDA, FL 33950(941) 621-6476(941) 347-7606 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 1336811082) is a healthcare organization registered as a family medicine in Punta Gorda, Florida and active in the NPI registry since October 2021. The organization holds a CLIA Waiver certificate valid through November 3, 2027 and lists Mary Haltigan, Director Of Revenue Cycle, as its authorized official.

NPPES Registry Identity

NPI1336811082
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMILLENNIUM PHYSICIAN GROUP LLC
Location Address150 W MCKENZIE ST STE 112Punta Gorda, FL 33950-5500
Mailing Address2675 Winkler Ave Fl 2Fort Myers, FL 33901-9342 · (877) 856-3774 · Fax (239) 599-2612
Phone(941) 621-6476
Fax(941) 347-7606
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 1336811082 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.
150 W MCKENZIE ST STE 112, Punta Gorda, FL 33950
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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

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 10D2104406

Millennium Physician Group · Punta Gorda, FL
Active · expires Nov 3, 2027
CLIA Number10D2104406
Laboratory TypePhysician Office
Certificate Effective DateNovember 4, 2025
Certificate Expiration DateNovember 3, 2027
Laboratory DirectorJuan Rivera
Laboratory Phone(941) 621-6476
Laboratory LocationMillennium Physician Group150 W Mckenzie St Suite 115, Punta Gorda, FL 33950
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 1336811082. 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 150 W Mckenzie St Ste 112, Punta Gorda, FL 33950. The listed phone number is (941) 621-6476.

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 10D2104406) is associated with this NPI, valid through November 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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.