Provider Demographics
NPI:1417383597
Name:TELLO, PAOLA V (PEDIATRIC ARNP)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:V
Last Name:TELLO
Suffix:
Gender:F
Credentials:PEDIATRIC ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N 35TH AVE STE 520
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5431
Mailing Address - Country:US
Mailing Address - Phone:954-265-2423
Mailing Address - Fax:954-961-4860
Practice Address - Street 1:1150 N 35TH AVE STE 520
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5431
Practice Address - Country:US
Practice Address - Phone:954-265-2423
Practice Address - Fax:954-961-4860
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9251277363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics