Provider Demographics
NPI:1346238805
Name:POZO, OSCAR (MD)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:POZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9248 SW 154TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1136
Mailing Address - Country:US
Mailing Address - Phone:305-439-1436
Mailing Address - Fax:305-554-0800
Practice Address - Street 1:11880 SW 40TH ST
Practice Address - Street 2:STE 211
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3584
Practice Address - Country:US
Practice Address - Phone:305-554-0808
Practice Address - Fax:305-554-0800
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME901302084P0800X, 2084P0804X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267696600Medicaid
H96130Medicare UPIN
FLU1590ZMedicare ID - Type Unspecified
FL267696600Medicaid
FLH96130Medicare UPIN