Provider Demographics
NPI:1194188649
Name:OSPINA, LIGIA VIVIANA
Entity Type:Individual
Prefix:
First Name:LIGIA
Middle Name:VIVIANA
Last Name:OSPINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13905 OSPREY LINKS RD APT 123
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-6149
Mailing Address - Country:US
Mailing Address - Phone:407-729-1796
Mailing Address - Fax:
Practice Address - Street 1:13905 OSPREY LINKS RD APT 123
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6149
Practice Address - Country:US
Practice Address - Phone:407-729-1796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator