Healthcare Provider Details

I. General information

NPI: 1366728677
Provider Name (Legal Business Name): JULIO DAVID OCHOA P.A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2011
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 VILLAGE SQUARE CROSSING STE 170
PALM BEACH GARDENS FL
33410-4549
US

IV. Provider business mailing address

1050 SE MONTEREY RD STE 400
STUART FL
34994-4512
US

V. Phone/Fax

Practice location:
  • Phone: 561-627-8500
  • Fax: 844-959-0418
Mailing address:
  • Phone: 772-288-2400
  • Fax: 772-419-0143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 9105837
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: