Healthcare Provider Details
I. General information
NPI: 1174048292
Provider Name (Legal Business Name): DR. JORGE JUAN OCHOA
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/09/2017
Last Update Date: 09/15/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13 CALLE J URB EXT HERMANAS DAVILA
BAYAMON PR
00959-4503
US
IV. Provider business mailing address
13 CALLE J URB EXT HERMANAS DAVILA
BAYAMON PR
00959-4503
US
V. Phone/Fax
- Phone: 787-622-5420
- Fax:
- Phone: 787-622-5420
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 15278 |
| License Number State | PR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 35542 |
| License Number State | PR |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | PR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: