Healthcare Provider Details

I. General information

NPI: 1548239254
Provider Name (Legal Business Name): MARIA J POCHCIAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601ST ST N
WINTER HAVEN FL
33881-4129
US

IV. Provider business mailing address

635 1ST ST N
WINTER HAVEN FL
33881-4129
US

V. Phone/Fax

Practice location:
  • Phone: 863-294-0670
  • Fax: 863-298-3200
Mailing address:
  • Phone: 863-294-0670
  • Fax: 863-298-3200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME69103
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME69103
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: