Provider Demographics
NPI:1235890922
Name:OSANDO, LATOYA TOLMANE (INDEPENDENT PROVIDER)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:TOLMANE
Last Name:OSANDO
Suffix:
Gender:F
Credentials:INDEPENDENT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 PAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1556
Mailing Address - Country:US
Mailing Address - Phone:419-788-3842
Mailing Address - Fax:
Practice Address - Street 1:1712 PAYNE AVE
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1556
Practice Address - Country:US
Practice Address - Phone:419-788-3842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3203100Medicaid