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NPI Code Detail

MEDICARE: MS. DEBRA J TANTILLO

MEDICARE: MS. DEBRA J TANTILLO
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
11041C0700XClinical Social WorkerSW5538FL

General Provider Information

NPI Number : 1376822981
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBRA J TANTILLO
Provider Business Mailing Address
First Line : 333 NW 46TH ST
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-4010
Country : US
Telephone Number : 954-732-5418
Fax Number : 954-772-1023
Provider Business Practice Location Address
First Line : 6750 N ANDREWS AVE STE 200
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-2180
Country : US
Telephone Number : 954-732-5418
Fax Number : 954-772-1023
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2011
Last Update Date : 05/14/2026

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