Provider Demographics
NPI:1477795813
Name:MAURY OCHOA, JOAQUIN SALUSTINO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAQUIN
Middle Name:SALUSTINO
Last Name:MAURY OCHOA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 SW 117TH AVE STE 416
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4828
Mailing Address - Country:US
Mailing Address - Phone:786-409-7662
Mailing Address - Fax:786-409-5881
Practice Address - Street 1:8200 SW 117TH AVE STE 416
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4828
Practice Address - Country:US
Practice Address - Phone:786-409-7662
Practice Address - Fax:786-409-5881
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1174092084N0400X, 208VP0014X
LAMD205441208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology