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General NPI Number Information
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NPI Number | 1740936806
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Entity Type | Organization
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Legal Business Name | MEDICINAL TECHNOLOGIES
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Dates
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Enumeration Date | 02/28/2022
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 4440 PGA BLVD STE 600
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City | PALM BEACH
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State | FL
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Zip | 33410
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Country | US
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Telephone | 833-363-6436
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Fax | 833-363-3466
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Provider Business Mailing Address
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Address Line | 1070 MONTGOMERY RD # 2055
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-7420
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Country | US
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Telephone | 833-363-6436
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Fax | 833-363-3466
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Authorized Official
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Title or Position | CEO OF MEDICINAL TECHNOLOGIES
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Name | DR. SHERYENE TEJEDA
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Credential |
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Telephone | 305-922-3713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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