Provider Demographics
NPI:1679088587
Name:TERES, RISHONA
Entity Type:Individual
Prefix:
First Name:RISHONA
Middle Name:
Last Name:TERES
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 1:1831 LAURELTON HALL LN
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-5959
Mailing Address - Country:US
Mailing Address - Phone:310-497-5136
Mailing Address - Fax:
Practice Address - Street 1:1500 S ORLANDO AVE STE 200
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-5500
Practice Address - Country:US
Practice Address - Phone:407-740-0909
Practice Address - Fax:407-740-7262
Is Sole Proprietor?:No
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9467238363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health