Individual provider Active NPI

Roberto Perez-Millan, MD, PA

  • Physical Medicine & Rehabilitation Physician
  • Tampa, FL
National Provider Identifier
1083670160
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME0088669 Issued in FL
Practice address
4600 N Habana Ave
Suite 28
Tampa, FL 33614-7166
Phone
(813) 873-2800
Fax
(813) 961-8593
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME0088669 FL Primary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X ME0088669 FL

Addresses

Primary practice location

4600 N Habana Ave
Suite 28
Tampa, FL 33614-7166

Mailing address

4600 N Habana Ave
Suite 28
Tampa, FL 33614-7166
Phone (813) 873-2800

Other identifiers 5

IdentifierTypeStateIssuer
1455194OtherFLCIGNA
16150OtherFLBLUE CROSS
2874886OtherFLUNITED
7935347OtherFLAETNA
2726645-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
ME0088669FLMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation and Electrodiagnostics PA Physical Medicine & Rehabilitation PastSince Sep 4, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1083670160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 N HABANA AVE",
            "address_2": "SUITE 28",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147166",
            "telephone_number": "813-873-2800",
            "fax_number": "813-873-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 N HABANA AVE",
            "address_2": "SUITE 28",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147166",
            "telephone_number": "813-873-2800",
            "fax_number": "813-961-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-MILLAN",
        "first_name": "ROBERTO",
        "credential": "MD, PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME0088669",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "ME0088669",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1455194",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "16150",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "2874886",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7935347",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2726645-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.