1669430534 NPI number — D M TEK INC

Table of content: MS. JENNIFER ANN MILAS RN (NPI 1871819003)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669430534 NPI number — D M TEK INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
D M TEK INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669430534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
701 NW FEDERAL HWY
Provider Second Line Business Mailing Address:
SUITE 206
Provider Business Mailing Address City Name:
STUART
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34994
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
772-692-2034
Provider Business Mailing Address Fax Number:
772-692-2035

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 NW FEDERAL HWY
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
STUART
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34994
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
772-692-2034
Provider Business Practice Location Address Fax Number:
772-692-2035
Provider Enumeration Date:
05/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LANG
Authorized Official First Name:
MILTON
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
772-692-2034

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)