Provider Demographics
NPI:1336434448
Name:TEJERA, AMELIE (PHD)
Entity type:Individual
Prefix:DR
First Name:AMELIE
Middle Name:
Last Name:TEJERA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 PIZARRO ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2424
Mailing Address - Country:US
Mailing Address - Phone:305-387-7850
Mailing Address - Fax:305-386-0827
Practice Address - Street 1:5600 SW 135TH AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-5182
Practice Address - Country:US
Practice Address - Phone:305-387-7850
Practice Address - Fax:305-386-0827
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4785103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist