Healthcare Provider Details

I. General information

NPI: 1962563528
Provider Name (Legal Business Name): DENNIS PAUL CIRILLO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 NURSING HOME DR
ARCADIA FL
34266-3870
US

IV. Provider business mailing address

6919 N DALE MABRY HWY STE 250
TAMPA FL
33614-3860
US

V. Phone/Fax

Practice location:
  • Phone: 863-993-7717
  • Fax: 863-491-4215
Mailing address:
  • Phone: 813-935-4210
  • Fax: 813-932-7940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number27280
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME140728
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: