Provider Demographics
NPI:1104975671
Name:JAMES R MILNE DO PA
Entity type:Organization
Organization Name:JAMES R MILNE DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CIMAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-776-7566
Mailing Address - Street 1:5333 N DIXIE HWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3414
Mailing Address - Country:US
Mailing Address - Phone:954-776-7566
Mailing Address - Fax:954-776-7544
Practice Address - Street 1:5333 N DIXIE HWY
Practice Address - Street 2:SUITE 204
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3414
Practice Address - Country:US
Practice Address - Phone:954-776-7566
Practice Address - Fax:954-776-7544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS00068632081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0549Medicare PIN
FL80951Medicare ID - Type UnspecifiedMEDICARE
FLF91523Medicare UPIN