JOHN TEDESCO (NPI# 1003839044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003839044 |
| Entity Type | Individual |
| Full Name | JOHN TEDESCO |
| Credential | DO |
| Practice Address |
2100 Via Bella Blvd Ste. 204 Land O Lakes FL 34639-5429 |
| Mailing Address |
38135 Market Square Zephyrhills FL 33542 |
| Practice Telephone | 8137513636 |
| Practice Fax Number | 8133771678 |
| Mailing Telephone | 8135284975 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2015-11-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OS6814 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 253803200 | 05 | |
| FL | RR MEDICARE | 080141113 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104271782 | John Tedesco | Student in an Organized Health Care Education/Training Program | 23 Old Mamaroneck Rd Apt 5g, White Plains, NY 10605-2015 | 2016-05-02 |
| 1790951747 | John Victor Tedesco | Surgery | 2025 Indian Rocks Rd S, Largo, FL 33774-1035 | 2008-04-30 |
| 1518971381 | John James Tedesco | Dietitian, Registered | 3495 Bailey Ave, Buffalo, NY 14215-1129 | 2006-07-28 |
| Street Address |
2100 VIA BELLA BLVD STE. 204 |
| City | LAND O LAKES |
| State | FL |
| Zip Code | 34639-5429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407891013 | James Kevin Poitras | Dermatology | 2100 Via Bella Blvd, Suite 101, Land O Lakes, FL 34639-5429 | 2006-06-18 |
| 1427501402 | Erin Lynn Godlewski | Nurse Practitioner | 2100 Via Bella Blvd, Ste 202, Land O Lakes, FL 34639-5429 | 2016-07-26 |
| 1629447784 | Madigan Dialysis LLC | Clinic/Center | 2100 Via Bella Blvd, Ste 104, Land O Lakes, FL 34639-5429 | 2015-09-18 |
| 1023414919 | Florida Medical Clinic LLC | Clinic/Center | 2100 Via Bella Blvd, Suite 103, Land O Lakes, FL 34639-5429 | 2014-11-05 |
| 1861783409 | Sivaram Rajan | Family Medicine | 2100 Via Bella Blvd, Suite 102, Land O Lakes, FL 34639-5429 | 2011-05-01 |
| 1497085930 | Dimple Rahul Desai | Specialist/Technologist, Other | 2100 Via Bella Blvd, Suite 103, Land O Lakes, FL 34639-5429 | 2010-01-06 |
| 1942443551 | Ravikanth Vydyula | Internal Medicine | 2100 Via Bella Blvd, Ste 201, Land O Lakes, FL 34639-5429 | 2009-04-13 |
| 1962683813 | Francine Marie Phillips | Physician Assistant | 2100 Via Bella Blvd, Suite 101, Land O Lakes, FL 34639-5429 | 2007-11-20 |
| 1811181837 | Beatrix Gitta Frasure | Nurse Practitioner | 2100 Via Bella Blvd, Suite 101, Land O Lakes, FL 34639-5403 | 2007-09-03 |
| 1346430055 | William Scott Blackshear | Anesthesiology | 2100 Via Bella Blvd, Suite 103, Land O Lakes, FL 34639-5429 | 2007-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730640962 | Destiny Marie Gaines | Counselor | 22703 Chesterview Loop Apt.211, Land O Lakes, FL 34639 | 2019-03-29 |
| 1720544380 | Central Florida Dermatology Institute, Pllc | Dermatology | 5450 Land O Lakes Blvd, Land O Lakes, FL 34639 | 2019-02-19 |
| 1073932174 | Erika Schaefer Meier | Nurse Practitioner | 2061 Collier Parkway, Land O Lakes, FL 34639 | 2014-04-16 |
| 1548526924 | George Alan Brant | Dermatology | 5450 Land O' Lakes Blvd, Land O' Lakes, FL 34639 | 2012-04-10 |
| 1679848956 | Floirda Medical Clinic Aco, LLC | Clinic/Center | 2150 Via Bella Blvd., Land O Lakes, FL 34639 | 2012-03-20 |
| 1336452408 | Jennifer T Gardner | Counselor | 5402 Swallow Dr, Land O Lakes, FL 34639 | 2010-07-19 |
| 1104094515 | Angela Claire Marina | Occupational Therapy Assistant | 7227 Land O Lakes Boulevard, Land O Lakes, FL 34639 | 2008-02-19 |
| 1154521151 | Kelly John Mulroy | Counselor | 3632 Land O'lakes Blvd, Suite 106, Land O'lakes, FL 34639 | 2007-07-19 |
| 1225248610 | Sandra J Aljure Estrada Dds Pa | Dentist | 21533 Villages Lakes Shopping Center, Land O Lakes, FL 34639 | 2007-05-23 |
| 1124233523 | Antionette Elizabeth Welch | Nurse Practitioner | 2121 Collier Parkway, The Little Clinic, Land O' Lakes, FL 34639 | 2007-05-11 |
| Find all providers in zip 34639 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770198723 | Florida Elite Management LLC | Family Medicine | 20525 Amberfield Dr Unit 104, Land O Lakes, FL 34638-4381 | 2020-09-15 |
| 1578178638 | Doreen Michele Villanueva | Family Medicine | 20851 Lake Talia Blvd, Land O Lakes, FL 34638-3701 | 2020-09-14 |
| 1609341833 | Medical Risk Solutions | Family Medicine | 20360 Gator Lane, Land O Lakes, FL 34638 | 2018-10-03 |
| 1366559932 | Julio Roberto Sanchez | Family Medicine | 4212 Mast Ct, Land O Lakes, FL 34639-3959 | 2006-08-23 |
| 1114959525 | William E Raduege | Family Medicine | 4348 County Road B, Unit B, Land O Lakes, WI 54540-9635 | 2006-07-07 |
| 1205807500 | Lisa Waggoner Barker | Family Medicine | 2061 Collier Pkwy, Land O Lakes, FL 34639-5202 | 2006-01-27 |
| 1194323717 | Mcr Health, Inc. | Family Medicine | 20360 Gator Ln Bldg 14, Land O Lakes, FL 34638-2802 | 2020-10-15 |
| 1386014652 | Alberto Gutierrez IIi | Family Medicine | 2100 Via Bella Blvd Ste 204, Land O Lakes, FL 34639-5429 | 2015-09-30 |
| 1861783409 | Sivaram Rajan | Family Medicine | 2100 Via Bella Blvd, Suite 102, Land O Lakes, FL 34639-5429 | 2011-05-01 |
| 1730497447 | Jelexza Janira Velez Gaetan | Family Medicine | 21507 Village Lakes Shopping Ctr Dr, Land O Lakes, FL 34639-5101 | 2010-09-15 |
| Find all providers in LAND O LAKES | ||||
| City | LAND O LAKES |
| Zip Code | 34639 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.