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Individual

DR. EDNA LILLIAN TELLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
12621 NW 8TH CT, CORAL SPRINGS, FL 33071-4425
(954) 632-2791
(954) 796-6584
Mailing address
1440 CORAL RIDGE DR, #121, CORAL SPRINGS, FL 33071-5433
(954) 632-2791
(954) 796-6584

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
08/09/2006
Last updated
07/08/2007
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