Healthcare Provider Details

I. General information

NPI: 1013211929
Provider Name (Legal Business Name): MRS. AUXILIADORA OJEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2011
Last Update Date: 01/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 SW 113TH AVE APT 105
MIAMI FL
33174-1188
US

IV. Provider business mailing address

31 SW 113TH AVE APT 105
MIAMI FL
33174-1188
US

V. Phone/Fax

Practice location:
  • Phone: 786-348-6058
  • Fax:
Mailing address:
  • Phone: 786-348-6058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License NumberCNA166035
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License NumberCNA166035
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberCNA166035
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberCNA166035
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberCNA166035
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: