MEDICARE: SUSANA NODAR TEJEDA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1376492090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSANA NODAR TEJEDA

Provider Business Mailing Address
First Line	:	2950 NW 168TH TER
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-4313
Country	:	US
Telephone Number	:	305-781-2481
Fax Number	:

Provider Business Practice Location Address
First Line	:	5901 MIAMI GARDENS DR STE 310B
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-6008
Country	:	US
Telephone Number	:	305-781-2481
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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Directions to “ SUSANA NODAR TEJEDA ” Practice Location

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