Provider Demographics
NPI:1417052531
Name:TEJEIRO, WILLIAM V (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:V
Last Name:TEJEIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3899 NW 7TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5551
Mailing Address - Country:US
Mailing Address - Phone:305-642-5661
Mailing Address - Fax:305-642-5664
Practice Address - Street 1:3899 NW 7TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5551
Practice Address - Country:US
Practice Address - Phone:305-642-5661
Practice Address - Fax:305-642-5664
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0058822207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064349100Medicaid
FL064349100Medicaid
FL11375Medicare ID - Type UnspecifiedMD PA