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General NPI Number Information
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NPI Number | 1912860016
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Entity Type | Organization
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Legal Business Name | TELLECHEA UROGYNECOLOGY CORP
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 7150 W 20TH AVE STE 614
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City | HIALEAH
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State | FL
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Zip | 33016-5511
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Country | US
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Telephone | 305-528-2453
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Fax |
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Provider Business Mailing Address
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Address Line | 7150 W 20TH AVE STE 614
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City | HIALEAH
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State | FL
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Zip | 33016-5511
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAURA TELLECHEA
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Credential | MD, MPH
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Telephone | 305-528-2453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number |
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License Number State |
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