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General NPI Number Information
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NPI Number | 1346356854
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Entity Type | Organization
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Legal Business Name | DAVID G. CISLO, D.O., P.A.
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 13815 TAMIAMI TRL NORTH PORT MEDICAL CENTER
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City | NORTH PORT
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State | FL
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Zip | 34287-2069
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Country | US
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Telephone | 941-426-4900
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Fax | 941-426-3994
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Provider Business Mailing Address
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Address Line | 13815 TAMIAMI TRL NORTH PORT MEDICAL CENTER
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City | NORTH PORT
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State | FL
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Zip | 34287-2069
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Country | US
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Telephone | 941-426-4900
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Fax | 941-426-3994
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. MICHELLE A ROBILLARD
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Credential |
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Telephone | 941-426-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS5665
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS6317
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP3380712
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License Number State | FL
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