Provider Demographics
NPI:1689462095
Name:OJEDA LEAL, ANGEL MIGUEL (SA-C)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:MIGUEL
Last Name:OJEDA LEAL
Suffix:
Gender:
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15164 SW 95TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1210
Mailing Address - Country:US
Mailing Address - Phone:786-772-9825
Mailing Address - Fax:
Practice Address - Street 1:15164 SW 95TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1210
Practice Address - Country:US
Practice Address - Phone:786-772-9825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-26
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25-237246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant