Healthcare Provider Details

I. General information

NPI: 1912092321
Provider Name (Legal Business Name): TAMPA BAY ENT & COSMETIC SURGERY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5105 N ARMENIA AVE
TAMPA FL
33603-1405
US

IV. Provider business mailing address

5105 N ARMENIA AVE
TAMPA FL
33603-1405
US

V. Phone/Fax

Practice location:
  • Phone: 813-879-8045
  • Fax:
Mailing address:
  • Phone: 813-879-8045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. DENNIS S AGLIANO
Title or Position: PRESIDENT/ PHYSICIAN
Credential: MD
Phone: 813-879-8045