MEDICARE: GISELLE OJEDA DPM 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	261QP1100X	Podiatric Clinic/Center	PO3532	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	:	1598023624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GISELLE OJEDA DPM PA

Provider Business Mailing Address
First Line	:	6039 COLLINS AVE
Second Line	:	311
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2203
Country	:	US
Telephone Number	:	786-259-7408
Fax Number	:

Provider Business Practice Location Address
First Line	:	6039 COLLINS AVE
Second Line	:	311
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2203
Country	:	US
Telephone Number	:	786-259-7408
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GISELLE OJEDA
Credential	:	DPM
Telephone Number	:	786-259-7408

Provider Enumeration Date	:	04/26/2012
Last Update Date	:	04/26/2012

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