Healthcare Provider Details

I. General information

NPI: 1235675422
Provider Name (Legal Business Name): MARISSA OCHOA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARISSA OCHOA APRN

II. Dates (important events)

Enumeration Date: 01/11/2017
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 N UNIVERSITY DR
PEMBROKE PINES FL
33024-6715
US

IV. Provider business mailing address

2300 N FLORIDA MANGO RD
WEST PALM BEACH FL
33409-6416
US

V. Phone/Fax

Practice location:
  • Phone: 954-989-5747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAC007376
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number9312351
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: