Healthcare Provider Details

I. General information

NPI: 1093666208
Provider Name (Legal Business Name): FT MED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8771 PERIMETER PARK CT STE 101
JACKSONVILLE FL
32216-2278
US

IV. Provider business mailing address

8771 PERIMETER PARK CT STE 101
JACKSONVILLE FL
32216-2278
US

V. Phone/Fax

Practice location:
  • Phone: 904-289-1554
  • Fax:
Mailing address:
  • Phone: 904-289-1554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. FREDERICO TEPEDINO
Title or Position: PRESIDENT
Credential: DMD
Phone: 904-289-1554