Organization Active NPI

Milla Pediatrics and Associates, Inc.

  • Pediatrics Physician
  • Lake City, FL
National Provider Identifier
1982775128
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME0058262 Issued in FL
Legal business name
MILLA PEDIATRICS AND ASSOCIATES, INC.
Practice address
426 SW Commerce Dr
Suite 101
Lake City, FL 32025-1505
Phone
(386) 755-2240
Fax
(386) 755-6598
NPI assigned
Nov 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2014

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

Authorized official

Name
Dr. Paulino Milla, M.D.
Title
President
Phone
(386) 755-2240

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X ME0058262 FL Primary

Addresses

Primary practice location

426 SW Commerce Dr
Suite 101
Lake City, FL 32025-1505

Mailing address

426 SW Commerce Dr
Suite 101
Lake City, FL 32025-1505
Phone (386) 755-2240

Other identifiers 2

IdentifierTypeStateIssuer
375159701MedicaidFL
375159702MedicaidFL

National Provider Directory

National Provider Directory

Locations

1847 SW Barnett Way
Lake City, FL 32025
Phone (386) 755-1440

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400544000000",
    "number": "1982775128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 SW COMMERCE DR",
            "address_2": "SUITE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251505",
            "telephone_number": "386-755-2240",
            "fax_number": "386-755-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 SW COMMERCE DR",
            "address_2": "SUITE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251505",
            "telephone_number": "386-755-2240",
            "fax_number": "386-755-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLA PEDIATRICS AND ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2014-05-20",
        "status": "A",
        "authorized_official_last_name": "MILLA",
        "authorized_official_first_name": "PAULINO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-755-2240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0058262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375159701",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375159702",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; 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.