Tello, Kenny
Tello, Kenny is an sole proprietor health care provider with primary practice located at 455 W Warren Ave , Longwood FL 32750-4038. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Tello, Kenny can be contacted via phone (407) 262-2220.Contact Information
Primary practice address
455 W Warren Ave
Longwood FL 32750-4038
Phone: (407) 262-2220
Fax: (407) 834-5011
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW11027 | Florida |
Profile Details
| NPI number | 1972931988 |
|---|---|
| LBN Legal business name | Tello, Kenny |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 30th, 2013 |
| Last updated | Aug 17th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972931988 | NPPES |
| Florida | MEDICAID | 106779400 |
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