Healthcare Provider Details

I. General information

NPI: 1508318585
Provider Name (Legal Business Name): ELIZABETH RODRIGUEZ OSORIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2016
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 ORANGE GROVE LN
APOPKA FL
32712-2141
US

IV. Provider business mailing address

1095 ORANGE GROVE LN
APOPKA FL
32712-2141
US

V. Phone/Fax

Practice location:
  • Phone: 407-552-8895
  • Fax:
Mailing address:
  • Phone: 407-552-8895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH22916
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: