Provider Demographics
NPI:1437184223
Name:TEJERO, ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:
Last Name:TEJERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9495 SW 72ND ST
Mailing Address - Street 2:B190
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3253
Mailing Address - Country:US
Mailing Address - Phone:305-598-8877
Mailing Address - Fax:305-596-7487
Practice Address - Street 1:9495 SW 72ND ST
Practice Address - Street 2:B190
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3253
Practice Address - Country:US
Practice Address - Phone:305-598-8877
Practice Address - Fax:305-596-7487
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0047090207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine