Healthcare Provider Details

I. General information

NPI: 1720968357
Provider Name (Legal Business Name): TATIANA QUIROZ-OSSABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TATIANA QUIROZ

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9018 PEMBERTON ST
SPRING HILL FL
34608-5549
US

IV. Provider business mailing address

9018 PEMBERTON ST
SPRING HILL FL
34608-5549
US

V. Phone/Fax

Practice location:
  • Phone: 352-340-7649
  • Fax:
Mailing address:
  • Phone: 352-340-7649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ12965
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: