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 1:858 BAINBRIDGE LOOP
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-2419
Mailing Address - Country:US
Mailing Address - Phone:786-626-6298
Mailing Address - Fax:
Practice Address - Street 1:8010 W COLONIAL DR UNIT 146-162
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-6101
Practice Address - Country:US
Practice Address - Phone:407-434-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-15
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146458207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine