Individual provider Active NPI

Lorenzo Oscar Telleria Jr., MD

  • Internal Medicine Physician
  • Fort Pierce, FL
National Provider Identifier
1821674953
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME152367 Issued in FL
Practice address
1505 Delaware Ave
Fort Pierce, FL 34950-3975
Phone
(772) 461-1402
Fax
(772) 252-7114
NPI assigned
Mar 19, 2021
Last updated
Oct 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME152367 FL Primary
Infectious Disease Physician 207RI0200X ME152367 FL

Addresses

Primary practice location

1505 Delaware Ave
Fort Pierce, FL 34950-3975

Mailing address

5827 Corporate Way
West Palm Beach, FL 33407-2000
Phone (561) 844-9443

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20211111002898 FL Practitioner - Infectious Disease 0345639308 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midway Specialty Care Center IncGroup PAC ID 9638306087, 30 clinicians

Practice addresses (Care Compare)

1505 Delaware Ave
Fort Pierce, FL 34950-3975
Phone (772) 461-1402

356 E Midway Rd
Fort Pierce, FL 34982-7148
Phone (772) 464-9746

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME152367FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Community Health Centers, Inc. CurrentSince Nov 1, 2021 Accepting new patients
Florida Community Health Centers Inc Current Accepting new patients
Florida Community Health Centers Inc Current Accepting new patients
Florida Community Health Centers Inc Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients
Florida Community Health Centers Inc Current Accepting new patients
Florida Community Health Centers Inc Current Accepting new patients
Florida Community Health Centers, Inc. Past Accepting new patients
Florida Community Health Centers, Inc. PastSince Jan 26, 2022 Accepting new patients

Locations

315 S W C Owen Ave
Clewiston, FL 33440
Phone (561) 996-9573

1505 Delaware Ave
Fort Pierce, FL 34950
Phone (772) 461-1140

15858 SW Warfield Blvd
Indiantown, FL 34956
Phone (772) 597-3596

1021 Health Park Dr
Moore Haven, FL 33471
Phone (863) 946-0405

1100 N Parrott Ave
Okeechobee, FL 34972
Phone (863) 763-1951

1701 SE Hillmoor Dr
Ste 19
Port St Lucie, FL 34952
Phone (772) 335-8455

3441 SE Willoughby Blvd
Stuart, FL 34994
Phone (772) 221-4000

5827 Corporate Way
West Palm Beach, FL 33407
Phone (561) 844-9443

5827 Corporate Way
Ste 135
West Palm Beach, FL 33407
Phone (561) 612-6524

Interoperability endpoints

  • Direct secure messaging: lorenzo.telleria.1@14865.direct.athenahealth.com

Organizations & group practices 9

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1821674953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5827 CORPORATE WAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072000",
            "telephone_number": "561-844-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 DELAWARE AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349503975",
            "telephone_number": "772-461-1402",
            "fax_number": "772-252-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLERIA",
        "first_name": "LORENZO",
        "middle_name": "OSCAR",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-19",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME152367",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME152367",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.