MEDICARE: MANUEL A OJEDA MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME83761	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326032533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANUEL A OJEDA MD PA

Provider Business Mailing Address
First Line	:	4351 ROYAL PALM AVE
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3018
Country	:	US
Telephone Number	:	305-861-5196
Fax Number	:	305-468-6258

Provider Business Practice Location Address
First Line	:	4351 ROYAL PALM AVE
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3018
Country	:	US
Telephone Number	:	305-861-5196
Fax Number	:	305-468-6258

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MANUEL ANTONIO OJEDA
Credential	:	MD
Telephone Number	:	305-861-5196

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	01/21/2010

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