MEDICARE: FANNY NATALIA GONZALEZ OCHOA MD

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	ME146458	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952840506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FANNY NATALIA GONZALEZ OCHOA MD

Provider Business Mailing Address
First Line	:	858 BAINBRIDGE LOOP
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-2419
Country	:	US
Telephone Number	:	786-626-6298
Fax Number	:

Provider Business Practice Location Address
First Line	:	8010 W COLONIAL DR UNIT 146-162
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-6101
Country	:	US
Telephone Number	:	407-434-8080
Fax Number	:

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

Provider Enumeration Date	:	02/15/2017
Last Update Date	:	11/06/2024

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