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Individual

NILDA TELO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12885 SW 42ND ST STE 2, MIAMI, FL 33175-3435
(786) 953-5583
Mailing address
12885 SW 42ND ST STE 2, MIAMI, FL 33175-3435
(786) 953-5583

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DO6988
DEPARTMENT OF HEALTH
FL
Enumeration date
03/01/2022
Last updated
03/01/2022
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