MEDICARE: CELIN ADOLFO ORELLANA OSORIO

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	246ZC0007X	Surgical Assistant	19-300	WI

General Provider Information

NPI Number	:	1881248672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELIN ADOLFO ORELLANA OSORIO

Provider Business Mailing Address
First Line	:	3295 NW 13TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-1860
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3295 NW 13TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-1860
Country	:	US
Telephone Number	:	224-401-6868
Fax Number	:

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

Provider Enumeration Date	:	07/30/2019
Last Update Date	:	07/30/2019

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