MEDICARE: DR. GISELLE OJEDA DPM

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	213E00000X	Podiatrist	PO3532	FL

General Provider Information

NPI Number	:	1710200860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GISELLE OJEDA DPM

Provider Business Mailing Address
First Line	:	7975 NW 154TH ST
Second Line	:	SUITE 390
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5863
Country	:	US
Telephone Number	:	786-259-7408
Fax Number	:	305-328-4022

Provider Business Practice Location Address
First Line	:	7975 NW 154TH ST
Second Line	:	390
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5863
Country	:	US
Telephone Number	:	786-259-7408
Fax Number	:

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

Provider Enumeration Date	:	03/03/2010
Last Update Date	:	06/20/2016

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