Provider Demographics
NPI:1396753620
Name:OCANA, ANTONIO L (MD)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:L
Last Name:OCANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6529 GUNN HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4021
Mailing Address - Country:US
Mailing Address - Phone:813-968-8314
Mailing Address - Fax:
Practice Address - Street 1:6553 GUNN HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-4021
Practice Address - Country:US
Practice Address - Phone:813-968-8314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95608207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276616700Medicaid
FL276616700Medicaid