Healthcare Provider Details

I. General information

NPI: 1689462095
Provider Name (Legal Business Name): ANGEL MIGUEL OJEDA LEAL SA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2025
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15164 SW 95TH ST
MIAMI FL
33196-1210
US

IV. Provider business mailing address

15164 SW 95TH ST
MIAMI FL
33196-1210
US

V. Phone/Fax

Practice location:
  • Phone: 786-772-9825
  • Fax:
Mailing address:
  • Phone: 786-772-9825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-537561
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number25-237
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: