Healthcare Provider Details

I. General information

NPI: 1184859365
Provider Name (Legal Business Name): JOSEPH M OSSORIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 07/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2464 N. UNIVERSITY DR
PEMBROKE PINES FL
33024
US

IV. Provider business mailing address

P.O. BOX 562966
MIAMI FL
33156
US

V. Phone/Fax

Practice location:
  • Phone: 305-267-7480
  • Fax: 305-267-7422
Mailing address:
  • Phone: 954-885-9874
  • Fax: 954-885-9876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberME0048178
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME48178
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: