Provider Demographics
NPI:1376168096
Name:MONTADA OCHOA, HOVARI JOSE (BCBA)
Entity type:Individual
Prefix:
First Name:HOVARI
Middle Name:JOSE
Last Name:MONTADA OCHOA
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2512 W BRADDOCK ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6826
Mailing Address - Country:US
Mailing Address - Phone:813-531-4021
Mailing Address - Fax:
Practice Address - Street 1:3401 S 78TH ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-6513
Practice Address - Country:US
Practice Address - Phone:813-372-8769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-56639103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106685200Medicaid