Basic Information
Provider Information
NPI: 1184719973
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AGLIANO
FirstName: DENNIS
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: SELECT PHYSICIANS ALLIANCE
Address2: 10002 PRINCESS PALM AVE. STE 332
City: TAMPA
State: FL
PostalCode: 336198327
CountryCode: US
TelephoneNumber: 8135717184
FaxNumber: 8136544695
Practice Location
Address1: FLORIDA ENT & ALLERGY
Address2: 5105 N ARMENIA AVE
City: TAMPA
State: FL
PostalCode: 336031405
CountryCode: US
TelephoneNumber: 8138798045
FaxNumber: 8138766504
Other Information
ProviderEnumerationDate: 10/04/2006
LastUpdateDate: 05/03/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207YS0123XME0016705FLN Allopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
207YX0905XME0016705FLN Allopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
207Y00000XME16705FLY Allopathic & Osteopathic PhysiciansOtolaryngology 

ID Information
IDTypeStateIssuerDescription
3560510005FL MEDICAID
03506510005FL MEDICAID


Home