Provider Demographics
NPI:1073866836
Name:OSORIO-ACOSTA, LUZ ADRIANA (PT)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:ADRIANA
Last Name:OSORIO-ACOSTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 NW 88TH AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-1869
Mailing Address - Country:US
Mailing Address - Phone:954-226-3501
Mailing Address - Fax:
Practice Address - Street 1:4105 NW 88TH AVE APT 1
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-1869
Practice Address - Country:US
Practice Address - Phone:954-226-3501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27271225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist