Miltiyia Blain, MSN, APRN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Melbourne, FL
NPI 1801625348 · NPPES record last updated Apr 9, 2025
Key facts
- NPI
- 1801625348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN11034913 (FL)
- Practice address
- 6100 Minton Rd NW Ste 102
Melbourne, FL 32907-1900 - Phone
- (321) 724-1171
- Fax
- (321) 724-9024
- NPI assigned
- Aug 1, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Omni Healthcare, Inc
Practice addresses (Care Compare)
6100 Minton Rd NW
Suite 102
Palm Bay, FL 32907-1900
Phone (321) 724-1171
Hospital & facility affiliations
- Palm Bay Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240905001320 | FL | Practitioner - Nurse Practitioner | 4981144904 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
Practice roles (6 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medfast Urgent Care Centers, LLC | Current |
Accepting new patients | |
| Omni Healthcare, Inc | Current | Accepting new patients | |
| Medfast Urgent Care Centers, LLC | Current |
Accepting new patients | |
| Omni Healthcare, Inc. | Current |
Accepting new patients | |
| Medfast Urgent Care Centers LLC | Current | Accepting new patients | |
| Omnihealthcare Inc | Past |
Accepting new patients |
Locations
7925 N Wickham Rd
Melbourne, FL 32940
Phone 32126861118561
6300 N Wickham Rd
Ste 132A
Melbourne, FL 32940
Phone (321) 253-4032
1344 S Apollo Blvd
Ste 406
Melbourne, FL 32901
Phone (321) 253-4032
6100 Minton Rd NW
Ste 102
Palm Bay, FL 32907
Phone (321) 724-1171
5005 Port St John Pkwy
Port St John, FL 32927
Phone (321) 504-0556
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- miltiyiablain@ohi.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11034913 | FL | Yes |
Addresses
Primary practice location
6100 Minton Rd NW Ste 102
Melbourne, FL 32907-1900
Mailing address
1024 Reverend Nathaniel L Harris St
Melbourne, FL 32901-7226
Phone (321) 290-0365
Other practice location 1
1024 Reverend Nathaniel L Harris St
Melbourne, FL 32901-7226
Phone (321) 290-0365
Other practice location 2
7925 N Wickham Rd
Melbourne, FL 32940-8356
Phone (321) 751-7222
Other providers in Melbourne, FL
- Theresa Marie Black
- Abigail Blackman
- Jiana Blackmon
- Josie R Blackmon
- Blackstone Hand Center, LLC
- Germaine M Blaine
- Katelyn Blair
- Michelle Catherine Blair
- Marie G Blaise
- Mary Ellen Teresa Blakesley
All providers in Melbourne, FL · Family Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.