Individual provider Active NPI

Ernesto J Millan, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Tampa, FL
National Provider Identifier
1083735856
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
ME0079748 Issued in FL
Practice address
5110 N. Habana Ave.
Suite 1
Tampa, FL 33614-6873
Phone
(813) 448-6755
Fax
(813) 304-2219
NPI assigned
Apr 2, 2007
Last updated
Apr 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X ME0079748 FL Primary

Addresses

Primary practice location

5110 N. Habana Ave.
Suite 1
Tampa, FL 33614-6873

Mailing address

5110 N Habana Ave
Suite 1
Tampa, FL 33614-6873
Phone (813) 448-6755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250227003676 FL Practitioner - Neurology 6204356629 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0079748FLMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J & J Rehab Medical Center Inc CurrentSince Feb 18, 2025 Accepting new patients
Ernesto J. Millan MD. PA. Neurology With Special Qualifications in Child Neurology Current Accepting new patients

Locations

3707 W Hamilton Ave
Ste 2
Tampa, FL 33614
Phone (813) 330-7033

5110 N Habana Ave
Ste 1
Tampa, FL 33614
Phone (813) 448-6755

Interoperability endpoints

  • Direct secure messaging: ernesto.millan.1@26223.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/26223/brand/1/csg/1/fhir/r4
  • Direct secure messaging: regionalhealthdiagnostics.ernestomillan@117073.advancedmd-direct.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1083735856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 N HABANA AVE",
            "address_2": "SUITE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146873",
            "telephone_number": "813-448-6755",
            "fax_number": "813-304-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 N. HABANA AVE.",
            "address_2": "SUITE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146873",
            "telephone_number": "813-448-6755",
            "fax_number": "813-304-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLAN",
        "first_name": "ERNESTO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "FL",
            "license": "ME0079748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.