Individual
DIMITRI MICHAEL TSALICKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11178 STATE ROAD 54 STE A, NEW PORT RICHEY, FL 34655-2266
(727) 372-4200
(727) 333-6371
Mailing address
11178 STATE ROAD 54 STE A, NEW PORT RICHEY, FL 34655-2266
(727) 372-4200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS17144
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111342800
—
FL
Enumeration date
04/17/2018
Last updated
08/24/2022
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