Active NPI
Fayven Teklehaimanot, DO
- Dermatology Physician
- Hialeah, FL
National Provider Identifier
1174208953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- UO9954
- Practice address
- 1475 W 49TH PL
Hialeah, FL 33012-3113 - Phone
- (786) 334-5618
- NPI assigned
- Jun 19, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | UO9954 | FL | Primary |
Addresses
Primary practice location
1475 W 49TH PL
Hialeah, FL 33012-3113
Mailing address
1475 W 49TH PL
Hialeah, FL 33012-3113
Phone (786) 334-5618
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UO9954 | FL | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1174208953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1475 W 49TH PL",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330123113",
"telephone_number": "786-334-5618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1475 W 49TH PL",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330123113",
"telephone_number": "786-334-5618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEKLEHAIMANOT",
"first_name": "FAYVEN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-19",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "FL",
"license": "UO9954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.