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General NPI Number Information
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NPI Number | 1962892034
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Entity Type | Organization
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Legal Business Name | ANTONIO TEJERO
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 01/28/2015
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Provider Practice Location Address
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Address Line | 9495 SUNSET DR STE B190
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City | MIAMI
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State | FL
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Zip | 33173-5419
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Country | US
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Telephone | 305-598-8877
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Fax | 305-596-7487
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Provider Business Mailing Address
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Address Line | 9495 SUNSET DR STE B190
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City | MIAMI
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State | FL
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Zip | 33173-5419
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Country | US
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Telephone | 305-598-8877
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Fax | 305-596-7487
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. ANTONIO TEJERO
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Credential | M.D.
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Telephone | 305-598-8877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME47090
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License Number State | FL
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