Healthcare Provider Details

I. General information

NPI: 1619669470
Provider Name (Legal Business Name): JESSENIA OJEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 NW 169TH ST
HIALEAH FL
33015-4210
US

IV. Provider business mailing address

8265 NW 186TH ST APT 905
HIALEAH FL
33015-2653
US

V. Phone/Fax

Practice location:
  • Phone: 786-615-8426
  • Fax:
Mailing address:
  • Phone: 305-519-1640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA22982
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI3184
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ11438
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: