Healthcare Provider Details

I. General information

NPI: 1508771908
Provider Name (Legal Business Name): MICHAEL ALEXIS OSPINA DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4557 AZALEA DR
NAPLES FL
34119-9055
US

IV. Provider business mailing address

4557 AZALEA DR
NAPLES FL
34119-9055
US

V. Phone/Fax

Practice location:
  • Phone: 786-291-6278
  • Fax:
Mailing address:
  • Phone: 786-291-6278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT45328
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: