Provider Demographics
NPI:1942439955
Name:MONTES DE OCA, GLORIA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:M
Last Name:MONTES DE OCA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 S RED RD STE 307
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5427
Mailing Address - Country:US
Mailing Address - Phone:305-302-1793
Mailing Address - Fax:
Practice Address - Street 1:7600 SW 57TH AVE STE 307
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5427
Practice Address - Country:US
Practice Address - Phone:305-302-1793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-11
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7546103TC0700X
FLPY 7546103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1851842884OtherGROUP TYPE 2 NPI