Provider Demographics
NPI:1952840506
Name:GONZALEZ OCHOA, FANNY NATALIA (MD)
Entity Type:Individual
Prefix:
First Name:FANNY
Middle Name:NATALIA
Last Name:GONZALEZ OCHOA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 E SEMORAN BLVD STE 2226
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-5733
Mailing Address - Country:US
Mailing Address - Phone:407-362-8032
Mailing Address - Fax:407-880-7792
Practice Address - Street 1:2200 E SEMORAN BLVD STE 2226
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-5733
Practice Address - Country:US
Practice Address - Phone:407-880-0011
Practice Address - Fax:407-880-7792
Is Sole Proprietor?:No
Enumeration Date:2017-02-15
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME146458207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program