MILLENNIUM PHYSICIAN GROUP LLC
NPI 1720750417
Family Medicine in Jacksonville, FL

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

Active since September 30, 2021CLIA Certified · 3 labs

11513 N MAIN ST, JACKSONVILLE, FL 32218(904) 751-6200(904) 751-1600 Get Directions Write a Review

NPPES record last updated: January 19, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 19, 2023, Sep 30, 2021 (2 updates tracked since 2021).

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About Millennium Physician Group Llc NPPES

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

MILLENNIUM PHYSICIAN GROUP LLC (NPI 1720750417) is a healthcare organization registered as a family medicine in Jacksonville, Florida and active in the NPI registry since September 2021. The organization holds a CLIA Waiver certificate valid through September 11, 2026 and lists Mary Haltigan, Director Of Revenue Cycle, as its authorized official.

NPPES Registry Identity

NPI1720750417

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameMILLENNIUM PHYSICIAN GROUP LLC

Location Address11513 N MAIN STJacksonville, FL 32218-4002

Mailing Address2675 Winkler Ave Fl 2Fort Myers, FL 33901-9342 · (877) 856-3774 · Fax (239) 599-2612

Phone(904) 751-6200

Fax(904) 751-1600

Organization SubpartNo

Authorized OfficialMary HaltiganDirector Of Revenue Cycle · (877) 856-3774

Enumeration DateSeptember 30, 2021

Last NPPES UpdateJanuary 19, 20232 updates tracked since enumeration

NPPES CertifiedJanuary 19, 2023

✔ NPI 1720750417 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.

11513 N MAIN ST, Jacksonville, FL 32218

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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 Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 10D0918712
Facility Type: Physician Office
Certificate Effective Date: September 12, 2024
Certificate Expiration Date: September 11, 2026
Laboratory Director: CHARLES J. HADDAD
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Millennium Physician Group Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.