Healthcare Provider Details

I. General information

NPI: 1780589895
Provider Name (Legal Business Name): OCASIO MEDICAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 LAURA OAKS 208 FL
KISSIMMEE FL
34747
US

IV. Provider business mailing address

100 E PINE ST STE 110
ORLANDO FL
32801-2759
US

V. Phone/Fax

Practice location:
  • Phone: 305-842-6887
  • Fax: 407-610-6863
Mailing address:
  • Phone: 305-842-6887
  • Fax: 407-610-6863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: JULIANA OCASIO
Title or Position: OWNER
Credential: APRN
Phone: 917-544-0533