Provider Demographics
NPI:1922199744
Name:JOSEPH S. CHIRILLO JR MDPA
Entity Type:Organization
Organization Name:JOSEPH S. CHIRILLO JR MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:S
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-926-0969
Mailing Address - Street 1:190 W DEARBORN ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-3237
Mailing Address - Country:US
Mailing Address - Phone:941-474-3359
Mailing Address - Fax:941-475-7573
Practice Address - Street 1:190 W DEARBORN ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-3237
Practice Address - Country:US
Practice Address - Phone:941-474-3359
Practice Address - Fax:941-475-7573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8706Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER