Provider Demographics
NPI:1265558977
Name:GARRY D MILLIEN MD PA
Entity type:Organization
Organization Name:GARRY D MILLIEN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MILLIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-432-5090
Mailing Address - Street 1:1501 FOREST HILL BLVD
Mailing Address - Street 2:STE 103
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6000
Mailing Address - Country:US
Mailing Address - Phone:561-432-5090
Mailing Address - Fax:561-433-1565
Practice Address - Street 1:1501 FOREST HILL BLVD
Practice Address - Street 2:STE 103
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6000
Practice Address - Country:US
Practice Address - Phone:561-432-5090
Practice Address - Fax:561-433-1565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0066418207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01-02503OtherUNITED HEALTH CARE
FL228-6290OtherAETNA
FLME0066418OtherFL LICENSE
FLP00283693OtherMCR RAILROAD
FL16495OtherWELLCARE
FL32570OtherBCBS
FL32570OtherBCBS
FL32570OtherBCBS
FLG21769Medicare UPIN
FLBM4116946OtherDEA