Search icon

MILLENNIUM PROVIDER GROUP, P.A. - Florida Company Profile

Company claim

Is this your business?

Get access!

Company Details

Entity Name: MILLENNIUM PROVIDER GROUP, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 08 Jan 2021 (5 years ago)
Document Number: P21000001666
FEI/EIN Number 86-1468274
Address: 6321 DANIELS PARKWAY, SUITE 200, FORT MYERS, FL, 33912
Mail Address: 6321 DANIELS PARKWAY, SUITE 200, FORT MYERS, FL, 33912
ZIP code: 33912
City: Fort Myers
County: Lee
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Dosoretz Arie Dr. Director 6321 DANIELS PARKWAY, SUITE 200, FORT MYERS, FL, 33912
HOLMES DAVID A Agent 99 NESBIT STREET, PUNTA GORDA, FL, 33950

National Provider Identifier

NPI Number:
1972234417
Certification Date:
2022-06-23

Authorized Person:

Name:
CHASITY CHASE
Role:
MARKET PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
8556747401

Documents

Name Date
ANNUAL REPORT 2024-04-23
ANNUAL REPORT 2023-04-17
ANNUAL REPORT 2022-08-31
Domestic Profit 2021-01-08

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 02 Jul 2025

Sources: Florida Department of State