Provider Demographics
NPI:1932540481
Name:OCHOTNY, MISTY NICHOL
Entity Type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:NICHOL
Last Name:OCHOTNY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 W LEMON ST APT 3202
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-1041
Mailing Address - Country:US
Mailing Address - Phone:813-465-8274
Mailing Address - Fax:
Practice Address - Street 1:1531 W LEMON ST APT 3202
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-1041
Practice Address - Country:US
Practice Address - Phone:813-465-8274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPSI29002390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPSI29002OtherFLORIDA PHARMACIST INTERN LICENSE