Individual
DR. JACOB EDWARD TELLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 303-9649
(407) 200-4947
Mailing address
2600 WESTHALL LN FL 4, MAITLAND, FL 32751-7102
(407) 303-9649
(407) 200-4947
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
57452
KY
2085R0204X
Vascular & Interventional Radiology Physician
57452
KY
2085R0204X
Vascular & Interventional Radiology Physician
ME 123702
FL
Other
Enumeration date
11/11/2010
Last updated
03/31/2023
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