Basic Information
| Provider Information | |||||||||
| NPI: | 1407828262 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILIAN | ||||||||
| FirstName: | NESTOR | ||||||||
| MiddleName: | EDUARDO | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4726 N HABANA AVE | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336147144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8138727582 | ||||||||
| FaxNumber: | 8138739591 | ||||||||
| Practice Location | |||||||||
| Address1: | 4726 N HABANA AVE | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336147144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8138727582 | ||||||||
| FaxNumber: | 8138739591 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2006 | ||||||||
| LastUpdateDate: | 05/13/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | ME049919 | FL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 064307600 | 05 | FL | MEDICAID |