Maryori Yuldana Tello, RD, LDN, CDM, CFPP

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND8502 Issued in FL

Practice address

850 6TH Ave S Ste 300
Jacksonville Beach, FL 32250-4256

Phone

(954) 654-1139

NPI assigned

Sep 26, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: telemed2u.maryoritello@160918.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Telehealth Specialty Medical Group

  • Emergency Medicine Physician
  • Roseville, CA
  • NPI 1326338237
  NPD
• Tele-Medicine Services Ny, PLLC

  • Internal Medicine Physician
  • Roseville, CA
  • NPI 1609663780
  NPD (past)

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1174247928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 16TH AVE N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503753",
            "telephone_number": "954-654-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 6TH AVE S STE 300",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322504256",
            "telephone_number": "954-654-1139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1103 16th Ave N",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322503753",
            "country_code": "US",
            "telephone_number": "954-654-1139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TELLO",
        "first_name": "MARYORI",
        "middle_name": "YULDANA",
        "credential": "RD, LDN, CDM, CFPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND8502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Raphael G Tamayo, MD
• John Calvin Tanner, DO
• Millicent Tanner, R.D.,C.D.E.
• Staci L Tanouye, M.D.
• Telepsychiatric Bridge Services
• Tender Chiropractic Health Center PA
• John G. Tender, D.C.
• Sandra J Terrazzano, ARNP, LMT
• Ryan James Terry, LMHC
• Kunal Thakkar, M.D.

• Registered Dietitian in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.