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General NPI Number Information
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NPI Number | 1104536820
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Entity Type | Individual
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Provider Name | OSMAR ALARCON SEGURA FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 12/05/2022
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 1109 SE PORT ST LUCIE BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-5332
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Country | US
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Telephone | 772-236-0277
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Fax |
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Provider Business Mailing Address
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Address Line | 1109 SE PORT ST LUCIE BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-5332
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Country | US
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Telephone | 954-982-4340
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11023153
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License Number State | FL
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