Provider Demographics
NPI:1790053726
Name:STAPLETON, TERI LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:TERI
Middle Name:LYNN
Last Name:STAPLETON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:339 CYPRESS PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3315
Mailing Address - Country:US
Mailing Address - Phone:407-846-8600
Mailing Address - Fax:407-343-8888
Practice Address - Street 1:339 CYPRESS PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3315
Practice Address - Country:US
Practice Address - Phone:407-343-3333
Practice Address - Fax:407-343-8888
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2016-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME113541207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010281100Medicaid
FL010281100Medicaid