MEDICARE: ISABELLA GOMEZ-OSORIO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1942010293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISABELLA GOMEZ-OSORIO

Provider Business Mailing Address
First Line	:	6314 TUPELO TRL
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34202-2846
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9481 HIGHLAND OAK DR UNIT 1815
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2518
Country	:	US
Telephone Number	:	941-773-0622
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2025
Last Update Date	:	01/09/2025

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Directions to “ ISABELLA GOMEZ-OSORIO ” Practice Location

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