Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | MA 63281 | FL |
NPI | 1336426469 |
---|---|
Provider Name | Jorge Luis Ochoa |
First Address | Miami, FL 33174-1169 |
Second Address | Miami, FL 33174-1169 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2011 |
Last Update Date | 03/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MA 63281 | MASSAGE THERAPY (01) | FL |