Provider Demographics
NPI:1417790619
Name:MONTES DE OCA, VICENTE
Entity type:Individual
Prefix:
First Name:VICENTE
Middle Name:
Last Name:MONTES DE OCA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11910 NORTHUMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-1326
Mailing Address - Country:US
Mailing Address - Phone:727-238-1725
Mailing Address - Fax:
Practice Address - Street 1:11910 NORTHUMBERLAND DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-1326
Practice Address - Country:US
Practice Address - Phone:727-238-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-15
Last Update Date:2024-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker