Healthcare Provider Details

I. General information

NPI: 1538359161
Provider Name (Legal Business Name): TERESA C HDEBECHE-ADAMS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 12/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 S CHICKASAW TRL SUITE 201
ORLANDO FL
32825-3501
US

IV. Provider business mailing address

258 S CHICKASAW TRL SUITE 201
ORLANDO FL
32825-3501
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-6626
  • Fax: 407-303-6634
Mailing address:
  • Phone: 407-303-6626
  • Fax: 407-303-6634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME110412
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberME110412
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: