Provider Demographics
NPI:1235000241
Name:VALDES EGIDO, TERESA (APRN)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:VALDES EGIDO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2462 E ILLIANA ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-5765
Mailing Address - Country:US
Mailing Address - Phone:407-223-8905
Mailing Address - Fax:
Practice Address - Street 1:2462 E ILLIANA ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-5765
Practice Address - Country:US
Practice Address - Phone:407-223-8905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11042092363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily