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NPI Code Detail

MEDICARE: JAIRO LUIS TEJADA M.D

MEDICARE: JAIRO LUIS TEJADA 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
1207R00000XInternal Medicine Physician328411LA

General Provider Information

NPI Number : 1497108302
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAIRO LUIS TEJADA M.D
Provider Business Mailing Address
First Line : 1395 NW 167TH ST
Second Line :
City : MIAMI GARDENS
State : FL
Zip : 33169-5710
Country : US
Telephone Number : 504-454-9020
Fax Number :
Provider Business Practice Location Address
First Line : 4710 S CARROLLTON AVE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119-6027
Country : US
Telephone Number : 504-454-9020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2016
Last Update Date : 08/18/2021

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Directions to “ JAIRO LUIS TEJADA M.D” Practice Location

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