Healthcare Provider Details

I. General information

NPI: 1518596212
Provider Name (Legal Business Name): TATIANA BEJARANO PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2020
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

V. Phone/Fax

Practice location:
  • Phone: 786-390-2411
  • Fax:
Mailing address:
  • Phone: 786-390-2411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZG1000X
TaxonomyMedical Geneticist (PhD) Specialist/Technologist
License NumberTRP863
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: