Provider Demographics
NPI:1083770176
Name:OSSORIO, BARBARA J (NP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:OSSORIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 990963
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-6058
Mailing Address - Country:US
Mailing Address - Phone:239-289-7971
Mailing Address - Fax:
Practice Address - Street 1:2900 12TH ST N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4528
Practice Address - Country:US
Practice Address - Phone:239-289-7971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-31
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL46950-2364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL46950-2OtherLICENSE
FL302716300Medicaid
FL46950-2OtherLICENSE
FLE1260Medicare ID - Type Unspecified