DR. DENNIS JOHN TISHKO (NPI# 1174591598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174591598 |
| Entity Type | Individual |
| Full Name | DR. DENNIS JOHN TISHKO |
| Credential | M.D. |
| Practice Address |
1625 Se 3rd Ave Ste 525 Fort Lauderdale FL 33316-2521 |
| Mailing Address |
1700 Nw 49th St Ste 125 Fort Lauderdale FL 33309-3750 |
| Practice Telephone | 9543554975 |
| Practice Fax Number | 9543555898 |
| Mailing Telephone | 9543554975 |
| Mailing Fax Number | 9543555898 |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2018-11-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | ME117485 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FLORIDA BLUE | 14V0A | 01 |
| FL | 011135100 | 05 |
| Street Address |
1625 SE 3RD AVE STE 525 |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33316-2521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124567664 | Vanessa Hanna | Nurse Practitioner | 1625 Se 3rd Ave Ste 525, Fort Lauderdale, FL 33316-2521 | 2017-02-16 |
| 1801208764 | Maria Farrell | Family Medicine | 1625 Se 3rd Ave Ste 525, Fort Lauderdale, FL 33316-2521 | 2014-05-27 |
| 1598194441 | Mahalah Louse U J Batto | Nurse Practitioner | 1625 Se 3rd Ave Ste 525, Fort Lauderdale, FL 33316-2521 | 2013-11-01 |
| 1447559620 | Shannon Beck Keating | Internal Medicine | 1625 Se 3rd Ave Ste 525, Fort Lauderdale, FL 33316-2521 | 2011-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064040 | Jonathan David Ortiz | Behavior Technician | 1717 Se 4 Ave, Fort Lauderdale, FL 33316 | 2020-05-15 |
| 1306311626 | Gateway Recovery Center, LLC | Counselor | 1421 Sw 4th Avenue, Suite B, Fort Lauderdale, FL 33316 | 2018-10-13 |
| 1588141626 | Natan Bastoky | Family Medicine | 1600 S Andrews Ave # Gme, Fort Lauderdale, FL 33316 | 2018-07-22 |
| 1104320126 | Kathleen Kanani Graham | Pharmacist | 1401 S. Federal Highway, Ft. Lauderdale, FL 33316 | 2018-03-23 |
| 1093224271 | Lacosta Therapy, LLC | Behavioral Analyst | 412 Se 15 St., #4, Ft. Lauderdale, FL 33316 | 2017-09-20 |
| 1124560370 | Yulia Rybalka | Pharmacist | 217 Se 10th Street, Ft Lauderdale, FL 33316 | 2016-11-04 |
| 1730635376 | Brian Alexander Reyes | Specialist/Technologist | 303 Se 3rd Ave, Ft Lauderdale, FL 33316 | 2016-09-01 |
| 1649726282 | Jennifer Tabares | Specialist/Technologist | 303 Southeast 3rd Av, Fort Lauderdale, FL 33316 | 2016-09-01 |
| 1609236850 | Diane Nicole Shilling | Nurse Practitioner | 1001 South Andrews Avenue, Suite 100, Ft. Lauderdale, FL 33316 | 2016-03-01 |
| 1396113239 | Victoria Rosado | Adult Companion | 150 Se 12th Street, 401(b), Fort Lauderdale, FL 33316 | 2015-09-09 |
| Find all providers in zip 33316 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205279411 | John Nicholas Melvan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Holy Cross Medical Group, Div of Cardiothoracic Surgery, 4725 North Federal Hwy, Suite 402, Fort Lauderdale, FL 33308 | 2013-04-08 |
| 1083967517 | Roman B. Klos Md,pa | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4800 Ne 20th Ter Ste 101, Fort Lauderdale, FL 33308-4510 | 2012-10-22 |
| 1699232058 | North Broward Hospital District | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1625 Se 3rd Ave Ste 501, Fort Lauderdale, FL 33316-2521 | 2019-02-21 |
| 1548532088 | Antonio G. Revilla Jr., M.d. P.a. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1880 E Commercial Blvd, Suite 3, Fort Lauderdale, FL 33308-3747 | 2012-01-30 |
| 1912202698 | Ted J. Carson Md, Pa. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1820 E Commercial Blvd, Fort Lauderdale, FL 33308-3725 | 2011-01-11 |
| 1215266366 | Henry Joseph Coleman | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 401 E Las Olas Blvd, Suite 130-153, Fort Lauderdale, FL 33301-2210 | 2009-12-21 |
| 1003026915 | Elite Cardiovascular Surgeons of South Florida | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1880 E Commercial Blvd, Suite 6, Fort Lauderdale, FL 33308-3747 | 2007-05-22 |
| 1275757205 | Wael Z Tamim M D P A | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1625 Se 3rd Ave, Suite 723, Fort Lauderdale, FL 33316-2521 | 2007-04-12 |
| 1356447155 | Ted J Carson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1820 E Commercial Blvd, Fort Lauderdale, FL 33308-3725 | 2006-09-16 |
| 1104867274 | Irving B David | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4725 N Federal Hwy, Fort Lauderdale, FL 33308-4603 | 2006-06-09 |
| Find all providers in FORT LAUDERDALE | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33316 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.