MEDICARE: TELO MEDICAL SERVICES INC

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
1	2085U0001X	Diagnostic Ultrasound Physician	11369	FL

General Provider Information

NPI Number	:	1356361224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TELO MEDICAL SERVICES INC

Provider Business Mailing Address
First Line	:	3282 SW 152ND PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-4825
Country	:	US
Telephone Number	:	305-301-6851
Fax Number	:	305-480-9256

Provider Business Practice Location Address
First Line	:	1790 W 49TH ST
Second Line	:	SUITE 305-3
City	:	HIALEAH
State	:	FL
Zip	:	33012-2992
Country	:	US
Telephone Number	:	305-826-4888
Fax Number	:	305-480-9256

Authorized Official
Title or Position	:	PRESIDENT OF TELO MEDICAL SERVICES
Name	:	MS. ELDA DIAZ
Credential	:	REDT, RCS, CCT
Telephone Number	:	305-301-6851

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	07/13/2009

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Directions to “TELO MEDICAL SERVICES INC ” Practice Location

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