NPIMap

Organization Active NPI

Millenium Medical Group Corp.

Doing business as Millenium Medical group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, FL
National Provider Identifier
1629585906
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MILLENIUM MEDICAL GROUP CORP.
Doing business as
Millenium Medical group
Practice address
2740 SW 97TH Ave
Suite Number a-111
Miami, FL 33165-3316
Phone
(786) 332-4330
Fax
(786) 332-4109
NPI assigned
Jan 8, 2018
Last updated
Sep 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Authorized official

Name
Ms. Damarys Suarez
Title
Administrator
Phone
(305) 613-0798

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X ARNP9227984 FL
Massage Therapist 225700000X MA64254 FL
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Adult Mental Health Clinic/Center 261QM0850X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

2740 SW 97TH Ave
Suite Number a-111
Miami, FL 33165-3316

Mailing address

2740 SW 97TH Ave Ste a-111
Miami, FL 33165-2681
Phone (786) 332-4330

Other names 1

  • Millenium Medical group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180416002781 FL Part B Supplier - Clinic/Group Practice 1355604877 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Miami, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Millenium Medical Group Corp3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2720 SW 97th Ave
Apt 105
Miami, FL 33165
Phone (305) 485-0909

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1629585906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 SW 97TH AVE STE A-111",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331652681",
            "telephone_number": "786-332-4330",
            "fax_number": "786-332-4109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 SW 97TH AVE",
            "address_2": "SUITE NUMBER A-111",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653316",
            "telephone_number": "786-332-4330",
            "fax_number": "786-332-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENIUM MEDICAL GROUP CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-08",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A",
        "authorized_official_last_name": "SUAREZ",
        "authorized_official_first_name": "DAMARYS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "305-613-0798",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ARNP9227984",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA64254",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Millenium Medical group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Millenium Medical group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.