MEDICARE: LATOYA OSBY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	11410379	FL

General Provider Information

NPI Number	:	1609274042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOYA OSBY

Provider Business Mailing Address
First Line	:	5536 METROWEST BLVD APT 308
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-2448
Country	:	US
Telephone Number	:	239-247-0800
Fax Number	:

Provider Business Practice Location Address
First Line	:	5536 METROWEST BLVD APT 308
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-2448
Country	:	US
Telephone Number	:	239-247-0800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2014
Last Update Date	:	12/17/2014

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Directions to “ LATOYA OSBY ” Practice Location

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