Provider Demographics
NPI:1821339193
Name:DELA CRUZ MCFETRIDGE, TERESA ALMARIO
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:ALMARIO
Last Name:DELA CRUZ MCFETRIDGE
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 1:5714 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-4260
Mailing Address - Country:US
Mailing Address - Phone:727-847-1745
Mailing Address - Fax:727-847-1745
Practice Address - Street 1:5714 MONROE ST
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-4260
Practice Address - Country:US
Practice Address - Phone:727-847-1745
Practice Address - Fax:727-847-1745
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL691014996Medicaid