Healthcare Provider Details

I. General information

NPI: 1811448111
Provider Name (Legal Business Name): OSMANY PUERTA GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9732 SW 24TH ST
MIAMI FL
33165-7513
US

IV. Provider business mailing address

1035 SW 62ND AVE
WEST MIAMI FL
33144-4907
US

V. Phone/Fax

Practice location:
  • Phone: 305-221-0660
  • Fax: 305-221-0696
Mailing address:
  • Phone: 305-305-5197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9297863
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: