| Millennium Medical Management Llc | |
|
7955 Spyglass Hill Rd Ste A Melbourne FL 32940-8249 | |
| (321) 255-6670 | |
| (321) 242-2545 |
| Full Name | Millennium Medical Management Llc |
|---|---|
| Speciality | Neurological Surgery |
| Location | 7955 Spyglass Hill Rd Ste A, Melbourne, Florida |
| Authorized Official Name and Position | Sun Mee Deukmedjian (FINANCIAL OFFICER) |
| Authorized Official Contact | 3217751290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Millennium Medical Management Llc 7955 Spyglass Hill Rd Ste A Melbourne FL 32940-8249 Ph: (321) 255-6670 | Millennium Medical Management Llc 7955 Spyglass Hill Rd Ste A Melbourne FL 32940-8249 Ph: (321) 255-6670 |
| NPI Number | 1366645376 |
|---|---|
| Provider Enumeration Date | 06/07/2007 |
| Last Update Date | 03/17/2022 |
| Medicare PECOS PAC ID | 3577656339 |
|---|---|
| Medicare Enrollment ID | O20070910000773 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366645376 | NPI | - | NPPES |
| 33435 | Other | FL | BCBSFL |
| 3612958 | Other | FL | AETNA |
| DG6510 | Other | FL | MEDICARE RAILROAD CARRIER |
| 613998300 | Other | FL | DOL ASC |
| 2921108 | Other | FL | CIGNA |
| Provider Name | Eugene B Freid |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1134197486 PECOS PAC ID: 9537196399 Enrollment ID: I20050722000685 |
| Provider Name | Jordan G Kuppinger |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124060496 PECOS PAC ID: 6406885029 Enrollment ID: I20050804000390 |
| Provider Name | Gonzalo Echavarria |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1821194382 PECOS PAC ID: 6901902816 Enrollment ID: I20070509000161 |
| Provider Name | Juan Santiago |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275521957 PECOS PAC ID: 2567422603 Enrollment ID: I20070815000626 |
| Provider Name | Bharat C Patel |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1457351322 PECOS PAC ID: 7214990167 Enrollment ID: I20071008000025 |
| Provider Name | Mark Davis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386646800 PECOS PAC ID: 6305936428 Enrollment ID: I20071213000186 |
| Provider Name | Stephanie E Haridopolos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548243785 PECOS PAC ID: 8022160126 Enrollment ID: I20090721000639 |
| Provider Name | Salim Lahlou |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831201961 PECOS PAC ID: 6901088178 Enrollment ID: I20110309000222 |
| Provider Name | Lori A Shellenback |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801179874 PECOS PAC ID: 2264604115 Enrollment ID: I20111019000057 |
| Provider Name | Trevan R Sedlak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033470844 PECOS PAC ID: 3476859380 Enrollment ID: I20160302001793 |
| Provider Name | Philip Michael Demola |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1942484688 PECOS PAC ID: 3971878703 Enrollment ID: I20171004003147 |
| Provider Name | Kamal T Patel |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1750720025 PECOS PAC ID: 6305183823 Enrollment ID: I20190122003251 |
| Provider Name | Tanya N Schrumpf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205832565 PECOS PAC ID: 3577568344 Enrollment ID: I20200414003769 |
| Provider Name | Matthew J Janzen |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1609226810 PECOS PAC ID: 1850683251 Enrollment ID: I20200727000774 |
| Provider Name | David Paz Calderon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790909968 PECOS PAC ID: 1052364247 Enrollment ID: I20210125002102 |
| Provider Name | Hans Allen Berndes |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881679546 PECOS PAC ID: 2466546619 Enrollment ID: I20220303000472 |
| Provider Name | Lakshman Sundaram |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1518268341 PECOS PAC ID: 6002270113 Enrollment ID: I20230907003133 |
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