Provider Demographics
NPI:1902895832
Name:MILLNS, JOHN LOUIS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LOUIS
Last Name:MILLNS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4531
Mailing Address - Country:US
Mailing Address - Phone:813-884-1626
Mailing Address - Fax:813-886-0589
Practice Address - Street 1:6001 MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4531
Practice Address - Country:US
Practice Address - Phone:813-884-1626
Practice Address - Fax:813-886-0589
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34694207ND0900X, 207ZD0900X
OH35.037604207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD53889Medicare UPIN
FL30202ZMedicare PIN