Provider Demographics
NPI:1992839963
Name:CUCCHI, ANTHONY P (DO)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:P
Last Name:CUCCHI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 W BOY SCOUT BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5766
Mailing Address - Country:US
Mailing Address - Phone:813-443-2108
Mailing Address - Fax:
Practice Address - Street 1:3902 MILLENIA BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-6407
Practice Address - Country:US
Practice Address - Phone:407-449-8620
Practice Address - Fax:407-205-1686
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS16887207XS0117X
MI5101015258207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIM09460119Medicare PIN