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General NPI Number Information
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NPI Number | 1457144404
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Entity Type | Individual
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Provider Name | RON RAYMOND CABASAL OSORIO
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Gender | Male
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 3900 UNIVERSITY BLVD S
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4331
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Country | US
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Telephone | 904-222-6656
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Fax | 904-222-6657
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Provider Business Mailing Address
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Address Line | 7923 CHERRY BLOSSOM DR N
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City | JACKSONVILLE
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State | FL
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Zip | 32216-0596
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Country | US
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Telephone | 904-575-0714
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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