Provider Demographics
NPI:1831549484
Name:OCHOA, STEPHANIE (PA-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:OCHOA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 CROSSWINDS DR N STE 200A
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-5473
Mailing Address - Country:US
Mailing Address - Phone:727-344-4651
Mailing Address - Fax:
Practice Address - Street 1:6700 CROSSWINDS DR N
Practice Address - Street 2:SUITE 200A
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8602
Practice Address - Country:US
Practice Address - Phone:727-344-4651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110006463363A00000X
MDC0007139363A00000X
CA60067363A00000X
FLPA9109463363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant