MEDICARE: OTTO L SECADA MDPA

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	ME60146	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881983658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OTTO L SECADA MDPA

Provider Business Mailing Address
First Line	:	7150 W 20TH AVE STE 209
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-5531
Country	:	US
Telephone Number	:	305-828-5677
Fax Number	:	305-828-9196

Provider Business Practice Location Address
First Line	:	7150 W 20TH AVE STE 209
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-5531
Country	:	US
Telephone Number	:	305-828-5677
Fax Number	:	305-828-9196

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. OTTO L SECADA
Credential	:	MD
Telephone Number	:	305-828-5677

Provider Enumeration Date	:	04/01/2011
Last Update Date	:	12/04/2025

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Directions to “OTTO L SECADA MDPA ” Practice Location

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