Provider Demographics
NPI:1033892823
Name:TELLO, BETTY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:TELLO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 LIVE OAK BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-8410
Mailing Address - Country:US
Mailing Address - Phone:407-593-2388
Mailing Address - Fax:407-593-2392
Practice Address - Street 1:2013 LIVE OAK BLVD STE C
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-8410
Practice Address - Country:US
Practice Address - Phone:407-593-2388
Practice Address - Fax:407-593-2392
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11027981363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care