Provider Demographics
NPI:1437608809
Name:OCHOA, ERICA L (APRN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:L
Last Name:OCHOA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:L
Other - Last Name:BLANCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:1150 N 35TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5428
Practice Address - Country:US
Practice Address - Phone:954-265-1490
Practice Address - Fax:954-989-0454
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9363994363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021844100Medicaid