Provider Demographics
NPI:1043816838
Name:OSORIO, KRISTINA (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:OSORIO
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1654 CELEBRATION BLVD UNIT 405
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5495
Mailing Address - Country:US
Mailing Address - Phone:407-701-2437
Mailing Address - Fax:
Practice Address - Street 1:4250 PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-2942
Practice Address - Country:US
Practice Address - Phone:407-933-3910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL52332255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer