Healthcare Provider Details

I. General information

NPI: 1962104752
Provider Name (Legal Business Name): AHBLELA R OCHOA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9981 S HEALTHPARK DR
FORT MYERS FL
33908-3618
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-5437
  • Fax:
Mailing address:
  • Phone: 239-343-7474
  • Fax: 239-343-4190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11025314
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: