MEDICARE: DR. DENNIS JOHN TISHKO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	ME117435	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14V0A	OTHER	FL	FLORIDA BLUE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174591598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS JOHN TISHKO M.D.

Provider Business Mailing Address
First Line	:	661 E ALTAMONTE DR STE 324
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5103
Country	:	US
Telephone Number	:	407-845-8354
Fax Number	:	954-888-3808

Provider Business Practice Location Address
First Line	:	661 E ALTAMONTE DR STE 324
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5103
Country	:	US
Telephone Number	:	407-845-8354
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	10/16/2025

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Directions to “ DR. DENNIS JOHN TISHKO M.D.” Practice Location

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