=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518163682
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIA B. BRUSCO OSSO A.R.N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 801 MEADOWS RD SUITE 118
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33486-2346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-392-4105
-----------------------------------------------------
Fax | 561-391-9355
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10561 HERITAGE FARMS RD
-----------------------------------------------------
City | LAKE WORTH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33467-6723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-491-8630
-----------------------------------------------------
Fax | 561-966-1449
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | A.R.N.P.1132562
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------