Healthcare Provider Details

I. General information

NPI: 1518732171
Provider Name (Legal Business Name): LUZ ELENA OSORIO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2023
Last Update Date: 11/23/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 S FEDERAL HWY
FT LAUDERDALE FL
33316-1222
US

IV. Provider business mailing address

19000 NE 3RD CT APT 401
MIAMI FL
33179-3844
US

V. Phone/Fax

Practice location:
  • Phone: 929-316-4698
  • Fax:
Mailing address:
  • Phone: 786-344-0354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number11023416
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: