MEDICARE: JOSE OJEA MD

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	207Q00000X	Family Medicine Physician	ME55349	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	:	1679518849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE OJEA MD

Provider Business Mailing Address
First Line	:	5700 LAKE WORTH RD
Second Line	:	#204
City	:	GREENACRES
State	:	FL
Zip	:	33463-4727
Country	:	US
Telephone Number	:	561-968-7968
Fax Number	:	561-964-4603

Provider Business Practice Location Address
First Line	:	1880 N CONGRESS AVE STE 303A
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-8675
Country	:	US
Telephone Number	:	561-734-8111
Fax Number	:	561-734-2993

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	05/02/2019

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