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NPI Code Detail

MEDICARE: DR. TYLER J TANTILLO DO

MEDICARE: DR. TYLER J TANTILLO DO
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
1207XS0106XOrthopaedic Hand Surgery Physician339588LA
2207X00000XOrthopaedic Surgery Physician339588LA

General Provider Information

NPI Number : 1215431762
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TYLER J TANTILLO DO
Provider Business Mailing Address
First Line : 951 N WASHINGTON AVE BLDG 4
Second Line :
City : TITUSVILLE
State : FL
Zip : 32796-2194
Country : US
Telephone Number : 321-268-6111
Fax Number :
Provider Business Practice Location Address
First Line : 951 N WASHINGTON AVE BLDG 4
Second Line :
City : TITUSVILLE
State : FL
Zip : 32796-2194
Country : US
Telephone Number : 321-268-6111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2018
Last Update Date : 04/16/2026

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