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General NPI Number Information
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NPI Number | 1508223256
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Entity Type | Individual
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Provider Name | INGRID TELASCO-MAURISSEAU ARNP
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Gender | Female
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 6766 FOREST HILL BLVD
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City | GREENACRES
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State | FL
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Zip | 33413-3321
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Country | US
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Telephone | 561-966-0015
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Fax | 888-875-1781
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Provider Business Mailing Address
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Address Line | 200 OCEANGATE STE 100
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City | LONG BEACH
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State | CA
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Zip | 90802-4317
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Country | US
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Telephone | 888-562-5442
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Fax | 844-861-1929
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 9211750
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9211750
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License Number State | FL
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