Healthcare Provider Details

I. General information

NPI: 1295485043
Provider Name (Legal Business Name): ERNESTO RICARDO OJEDA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 BAPTIST WAY STE 202
HOMESTEAD FL
33033-7600
US

IV. Provider business mailing address

PO BOX 198054
ATLANTA GA
30384-8054
US

V. Phone/Fax

Practice location:
  • Phone: 786-243-8444
  • Fax: 786-576-0416
Mailing address:
  • Phone: 786-662-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA197975
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME181105
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: