Provider Demographics
NPI:1023031499
Name:CONSULTA MEDICA OCHOA
Entity Type:Organization
Organization Name:CONSULTA MEDICA OCHOA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-799-9800
Mailing Address - Street 1:200 CALLE RICARDI
Mailing Address - Street 2:PALACIOS REALES
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-4917
Mailing Address - Country:US
Mailing Address - Phone:787-799-9800
Mailing Address - Fax:787-799-9800
Practice Address - Street 1:ROAD 167 KM 14.8
Practice Address - Street 2:BO BUENA VISTA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-799-9800
Practice Address - Fax:787-799-9800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14396208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty