Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 046631 | GA |
Y | 2084N0400X | Neurologist | 30288 | AL |
N | 2084N0400X | Neurologist | AL30288 | AL |
N | 2084N0400X | Neurologist | ME79998 | FL |
N | 2084N0600X | Clinical Neurophysiologist | 30288 | AL |
N | 2084N0600X | Clinical Neurophysiologist | ME79998 | FL |
NPI | 1013986041 |
---|---|
Provider Name | Dr. Juan Gonzalo Ochoa |
First Address | Mobile, AL 36640-0480 |
Second Address | Mobile, AL 36604-1512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 14/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000797332A | (05) | GA |
000797332B | (05) | GA |
130018720 | RAILROAD MEDICARE (01) | FL |
2547317-00 | (05) | FL |
G73142 | (02) | FL |