Provider Demographics
NPI:1518483684
Name:CARDILLO, THOMAS MATTHEW (ARNP)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MATTHEW
Last Name:CARDILLO
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
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Mailing Address - Street 1:5400 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-3833
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:3021 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-3300
Practice Address - Country:US
Practice Address - Phone:352-688-3379
Practice Address - Fax:352-398-1333
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-20
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9325532363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health