Provider Demographics
NPI:1235438011
Name:OSORIO-SMITH, MILENA (MD)
Entity Type:Individual
Prefix:
First Name:MILENA
Middle Name:
Last Name:OSORIO-SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2789 S STATE ROAD 7 STE 100200
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-9359
Mailing Address - Country:US
Mailing Address - Phone:561-898-5100
Mailing Address - Fax:502-508-4773
Practice Address - Street 1:2789 S STATE ROAD 7 STE 100200
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-9359
Practice Address - Country:US
Practice Address - Phone:561-898-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-20
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 109260207Q00000X
FLME109260207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine