Active NPI
Teressa Gayle O'Daniel, 03/07/2007
- Other Technician
- Winter Garden, FL
National Provider Identifier
1033364716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- OTA5830
- Practice address
- 1093 Narrow Gauge CT
Winter Garden, FL 34787-2124 - Phone
- (407) 656-0362
- NPI assigned
- Nov 24, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | OTA5830 | FL | Primary |
Addresses
Primary practice location
1093 Narrow Gauge CT
Winter Garden, FL 34787-2124
Mailing address
1093 Narrow Gauge CT
Winter Garden, FL 34787-2124
Phone (407) 656-0362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTA5830 | FL | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227484800000",
"number": "1033364716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1093 NARROW GAUGE CT",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347872124",
"telephone_number": "407-656-0362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1093 NARROW GAUGE CT",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347872124",
"telephone_number": "407-656-0362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'DANIEL",
"first_name": "TERESSA",
"middle_name": "GAYLE",
"credential": "03/07/2007",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-24",
"last_updated": "2008-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "FL",
"license": "OTA5830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Garden, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.