Provider Demographics
NPI:1730321803
Name:OCHOA, OTTO F
Entity Type:Individual
Prefix:
First Name:OTTO
Middle Name:F
Last Name: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 1:10728 SW 7TH ST
Mailing Address - Street 2:APT# 28
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1592
Mailing Address - Country:US
Mailing Address - Phone:305-297-2913
Mailing Address - Fax:
Practice Address - Street 1:10728 SW 7TH ST
Practice Address - Street 2:APT# 28
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1592
Practice Address - Country:US
Practice Address - Phone:305-297-2913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst