MEDICARE: MRS. DELIA OCHOA-GARCIA DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	057705	FL
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	OS7705	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	58859Y	OTHER	FL	MEDICARE ID

General Provider Information

NPI Number	:	1194829747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DELIA OCHOA-GARCIA DO

Provider Business Mailing Address
First Line	:	1000 PARK CENTRE BLVD
Second Line	:	SUITE 100
City	:	MIAMI
State	:	FL
Zip	:	33169-5373
Country	:	US
Telephone Number	:	305-621-0023
Fax Number	:	305-623-9188

Provider Business Practice Location Address
First Line	:	5961 NW 173RD DRIVE
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33015
Country	:	US
Telephone Number	:	305-556-7500
Fax Number	:	305-503-3476

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	09/20/2012

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