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General NPI Number Information
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NPI Number | 1144967407
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Entity Type | Organization
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Legal Business Name | AB TEL MED
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 618 E SOUTH ST STE 500
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City | ORLANDO
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State | FL
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Zip | 32801-2986
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Country | US
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Telephone | 407-495-1070
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Fax |
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Provider Business Mailing Address
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Address Line | 618 E SOUTH ST STE 500
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City | ORLANDO
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State | FL
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Zip | 32801-2986
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Country | US
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Telephone | 407-495-1070
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Fax |
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Authorized Official
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Title or Position | AMBR
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Name | JAYARAM BRINDALA
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Credential | MD
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Telephone | 407-495-1070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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