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Provider Information for 1740936806

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MEDICINAL TECHNOLOGIES

Organization Subpart: NO

Organization NPI: 1740936806

Calendar   Last Updated:  2022-02-28
  Certification Date:  2022-02-09

Details

Name Value
NPI 1740936806
Enumeration Date 2022-02-28
NPI Type 2- Organization
Status Active
Authorized Official Information Name: DR. SHERYENE TEJEDA
Title: CEO OF MEDICINAL TECHNOLOGIES
Phone: 305-922-3713
Mailing Address 1070 MONTGOMERY RD # 2055
ALTAMONTE SPRINGS, FL 32714-7420
United States

Phone: 833-363-6436 | Fax: 833-363-3466
View Map External Link
Primary Practice Address 4440 PGA BLVD STE 600
PALM BEACH, FL 33410
United States

Phone: 833-363-6436 | Fax: 833-363-3466
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 291U00000X - Clinical Medical Laboratory