Provider Demographics
NPI:1194764035
Name:MCMILLAN, DENIS (MD)
Entity type:Individual
Prefix:DR
First Name:DENIS
Middle Name:
Last Name:MCMILLAN
Suffix:
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 1:2301 NORTH UNIVERSITY DRIVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024
Mailing Address - Country:US
Mailing Address - Phone:954-963-6500
Mailing Address - Fax:954-963-6233
Practice Address - Street 1:2301 NORTH UNIVERSITY DRIVE
Practice Address - Street 2:SUITE 112
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024
Practice Address - Country:US
Practice Address - Phone:954-963-6500
Practice Address - Fax:954-963-6233
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0043290207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043869300Medicaid
FL94299XMedicare PIN