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General NPI Number Information
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NPI Number | 1659188175
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Entity Type | Individual
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Provider Name | CARLOS SHAYAN OSORIO PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 4411 N HABANA AVE
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City | TAMPA
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State | FL
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Zip | 33614-7211
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Country | US
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Telephone | 813-872-2771
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Fax |
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Provider Business Mailing Address
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Address Line | 9013 SHELDON CHASE DR
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City | TAMPA
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State | FL
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Zip | 33635-1094
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Country | US
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Telephone | 772-200-7078
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT42127
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License Number State | FL
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