MEDICARE: DEBORAH PITTENGER TEDESCO ARNP

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	363L00000X	Nurse Practitioner	ARNP2751012	FL
2	363LA2200X	Adult Health Nurse Practitioner	APRN2751012	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	500025318	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	Y0691	OTHER	FL	BCBS
4	ARNP2751012	OTHER	FL	MEDICAL LICENSE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912956095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH PITTENGER TEDESCO ARNP

Provider Business Mailing Address
First Line	:	265 E ROLLINS ST STE 5300
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5519
Country	:	US
Telephone Number	:	407-821-3555
Fax Number	:

Provider Business Practice Location Address
First Line	:	265 E ROLLINS ST STE 5300
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5519
Country	:	US
Telephone Number	:	407-821-3555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	03/01/2023

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