Provider Demographics
NPI:1265187462
Name:LILLO, ADAM R (ARNP)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:R
Last Name:LILLO
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:352-567-0188
Mailing Address - Fax:813-355-5084
Practice Address - Street 1:2727 W DR MARTIN LUTHER KING JR BLVD STE 760
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6358
Practice Address - Country:US
Practice Address - Phone:813-280-7300
Practice Address - Fax:813-377-1396
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11017881363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily