Victoria Sydeco Tayengco-Maisog, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME103467 Issued in FL

Practice address

9304 Trieste Drive
Fort Myers, FL 33913

Phone

(239) 707-4155

Fax

(239) 415-0028

NPI assigned

Oct 12, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Victoria Sydeco Tayengco Other name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1144572249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9304 TRIESTE DRIVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33913",
            "telephone_number": "239-707-4155",
            "fax_number": "239-415-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9304 TRIESTE DRIVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33913",
            "telephone_number": "239-707-4155",
            "fax_number": "239-415-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYENGCO-MAISOG",
        "first_name": "VICTORIA",
        "middle_name": "SYDECO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-12",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME103467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "TAYENGCO",
            "middle_name": "SYDECO",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Karen Gayle Tasman, ARNP
• Taylor Tate
• Abigail Elizabeth Tattersall, PAC
• Ana Taveras Pantaleon, M.D
• Julissa Taveras, ARNP
• Ailime Taylor
• Alexis Maria Taylor
• Amy Nicole Taylor, TCM BA
• Bill Taylor, MA
• David K Taylor, DC

• Pediatrics Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.