Provider Demographics
NPI:1952604498
Name:ANGEL E. TEJEDA, M.D., P.A.
Entity Type:Organization
Organization Name:ANGEL E. TEJEDA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:TEJEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-693-6305
Mailing Address - Street 1:4305 E 8TH AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-2465
Mailing Address - Country:US
Mailing Address - Phone:305-693-6305
Mailing Address - Fax:305-456-0082
Practice Address - Street 1:4305 E 8TH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-2465
Practice Address - Country:US
Practice Address - Phone:305-693-6305
Practice Address - Fax:305-456-0082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65366207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty