Louis P Cerillo, DDS, PA

Individual provider Active NPI General Practice Dentistry · Tampa, FL

NPI 1619199023 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1619199023
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN11574 (FL)
Practice address
15277 Amberly Dr
Somerset Professional Park
Tampa, FL 33647-2155
Phone
(813) 971-1688
Fax
(813) 971-4322
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
DN11574FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Louis P Cerillo, DDS, PA Past Accepting new patients
Florida Dental Professionals, P.a. General Practice Past
since May 29, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN11574 FL Yes

Addresses

Primary practice location

15277 Amberly Dr
Somerset Professional Park
Tampa, FL 33647-2155

Mailing address

15277 Amberly Dr
Somerset Professional Park
Tampa, FL 33647-2155
Phone (813) 971-1688

Other providers in Tampa, FL

All providers in Tampa, FL · General Practice Dentistry in Florida

Sources for this page

Verify at the official NPI Registry.