| Organization Name: | MILLENIUM MEDICAL CARE INC |
| NPI Number: | 1710197686 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDWIN BONILLA (OWNER) |
| Mailing Address: | 39 Calle Munoz Rivera Aguas Buenas Aguas Buenas |
| State: | PR US |
| Postal Code: | 007033233 |
| Phone Number: | 7877327424 |
| Fax Number: | 7877576306 |
| NPI Enumeration Date: | 05/22/2007 |
| NPI Last Update Date: | 01/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 11614 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |