Provider Demographics
NPI:1356090393
Name:TEODORI, ELIZABETH GIULIANA
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:GIULIANA
Last Name:TEODORI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 BARCELONA WAY
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1748
Mailing Address - Country:US
Mailing Address - Phone:754-245-5140
Mailing Address - Fax:
Practice Address - Street 1:1513 BARCELONA WAY
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33327-1748
Practice Address - Country:US
Practice Address - Phone:754-245-5140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician