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NPI Code Detail

MEDICARE: DR. MARICEL TEJEDA-OYOLA M.D.

MEDICARE: DR. MARICEL TEJEDA-OYOLA M.D.
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
1208D00000XGeneral Practice Physician15447PR

General Provider Information

NPI Number : 1487627782
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARICEL TEJEDA-OYOLA M.D.
Provider Business Mailing Address
First Line : 2309 E 15TH ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-6345
Country : US
Telephone Number : 787-604-2756
Fax Number :
Provider Business Practice Location Address
First Line : 2309 E 15TH ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-6345
Country : US
Telephone Number : 787-604-2756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 12/07/2015

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