Provider Demographics
NPI:1417845488
Name:PEREZ OCHOA, PABLO A
Entity type:Individual
Prefix:
First Name:PABLO
Middle Name:A
Last Name:PEREZ OCHOA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 BEULAH AVE
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-2801
Mailing Address - Country:US
Mailing Address - Phone:352-267-1035
Mailing Address - Fax:
Practice Address - Street 1:907 BEULAH AVE
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-2801
Practice Address - Country:US
Practice Address - Phone:352-267-1035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician