Provider Demographics
NPI:1790275931
Name:ALAEI TALEGHANI, POONEH
Entity type:Individual
Prefix:
First Name:POONEH
Middle Name:
Last Name:ALAEI TALEGHANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10016 WELLNESS WAY STE 130
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-7176
Mailing Address - Country:US
Mailing Address - Phone:407-650-0248
Mailing Address - Fax:
Practice Address - Street 1:10016 WELLNESS WAY STE 130
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-7176
Practice Address - Country:US
Practice Address - Phone:407-650-0248
Practice Address - Fax:407-671-4155
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4138213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery