Organization
PERSONALIZED PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDNA L TELLO M.D. (OWNER/FOUNDER)
(954) 632-2791
Entity
Organization
Contact information
Practice address
12621 NW 8TH CT, CORAL SPRINGS, FL 33071-4425
(954) 632-2791
(954) 752-7845
Mailing address
1440 CORAL RIDGE DR # 121, CORAL SPRINGS, FL 33071-5433
(954) 632-2791
(954) 752-7845
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME80694
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2606259
—
FL
Enumeration date
02/26/2015
Last updated
02/26/2015
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