OrganizationActive
Millennium Physician Group LLC
NPI 1700558574 · Family Medicine Physician · Fernandina Beach, FL
Provider details
- NPI number
- 1700558574
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mary Haltigan, Director of Revenue Cycle(877) 856-3774
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1340 S 18th St Ste 204
Fernandina Beach, FL 32034-4733
Phone: (904) 261-0643
Fax: (941) 277-4082
Street-level locationGet directions
Mailing address
2675 Winkler Ave Fl 2
Fort Myers, FL 33901-9342
Registry dates
- Enumerated
- 2021-09-30
- Last updated
- 2023-01-19
- Certified
- 2023-01-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.