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NPI Code Detail

MEDICARE: MRS. ANNA TEDESCO

MEDICARE: MRS. ANNA TEDESCO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSA 9472FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285858340
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANNA TEDESCO
Provider Business Mailing Address
First Line : PO BOX 91003
Second Line :
City : LAKELAND
State : FL
Zip : 33804-1003
Country : US
Telephone Number : 863-944-8788
Fax Number : 863-298-0299
Provider Business Practice Location Address
First Line : 150 AVENUE B SE
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33880-3037
Country : US
Telephone Number : 863-294-1429
Fax Number : 863-298-0299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 08/08/2008

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Directions to “ MRS. ANNA TEDESCO ” Practice Location

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