Basic Information
| Provider Information | |||||||||
| NPI: | 1962563528 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CIRILLO | ||||||||
| FirstName: | DENNIS | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6919 N DALE MABRY HWY STE 250 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336143860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139354210 | ||||||||
| FaxNumber: | 8139327940 | ||||||||
| Practice Location | |||||||||
| Address1: | 316 NURSING HOME DR | ||||||||
| Address2: | |||||||||
| City: | ARCADIA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342663870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8639937717 | ||||||||
| FaxNumber: | 8634914215 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2006 | ||||||||
| LastUpdateDate: | 08/05/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | 27280 | CO | N | Allopathic & Osteopathic Physicians | Plastic Surgery | 208200000X | ME140728 | FL | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.