Provider Demographics
NPI:1144643073
Name:DR OSORIO C.S.P
Entity type:Organization
Organization Name:DR OSORIO C.S.P
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDISSON
Authorized Official - Middle Name:H
Authorized Official - Last Name:OSORIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-955-6440
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:PR
Mailing Address - Zip Code:00677-0159
Mailing Address - Country:US
Mailing Address - Phone:787-826-2858
Mailing Address - Fax:787-826-6428
Practice Address - Street 1:CALLE MANUEL B MALAVE NUMERO 15
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-0000
Practice Address - Country:US
Practice Address - Phone:787-826-2858
Practice Address - Fax:787-826-6428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6306261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care