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General NPI Number Information
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NPI Number | 1174106157
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Entity Type | Individual
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Provider Name | KELYS LEONOR CABALLERO OSORIO MD
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Gender | Female
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Dates
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Enumeration Date | 04/28/2021
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 111 NW 183RD ST
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City | MIAMI
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State | FL
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Zip | 33169-4537
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Country | US
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Telephone | 305-655-0702
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Fax |
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Provider Business Mailing Address
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Address Line | 116 NW 9TH TER APT 411
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-3968
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Country | US
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Telephone | 786-942-7522
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 1371
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 15608I
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 1371
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License Number State | FL
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