=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477752186
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LUCIEN J. PARRILLO MD, MPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/12/2007
-----------------------------------------------------
Last Update Date | 09/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4310 S FLORIDA AVE
-----------------------------------------------------
City | LAKELAND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33813-1631
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 863-606-5937
-----------------------------------------------------
Fax | 863-606-5936
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4310 S FLORIDA AVE
-----------------------------------------------------
City | LAKELAND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33813-1631
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 863-606-5937
-----------------------------------------------------
Fax | 863-606-5936
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208VP0014X
-----------------------------------------------------
Taxonomy Name | Interventional Pain Medicine Physician
-----------------------------------------------------
License Number | ME139340
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------