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Individual
MARY ANN TESALONA
Active
Individual
MARY ANN TESALONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0063400
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18442
BLUE CROSS & BLUE SHIELD
FL
05
—
371959600
—
FL
Enumeration date
07/18/2005
Last updated
01/12/2023
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