Organization
ATHLETAMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EDNA LILLIAN TELLO MD (MD / OWNER)
(954) 632-2791
Entity
Organization
Contact information
Practice address
12621 NW 8TH COURT, CORAL SPRINGS, FL 33071
(954) 543-1760
(954) 752-7845
Mailing address
1440 CORAL RIDGE DR, #121, CORAL SPRINGS, FL 33071
(954) 543-1760
(954) 752-7845
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
03/19/2021
Last updated
03/19/2021
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