Provider Demographics
NPI:1417252107
Name:OSPINA, PATRICIA LERIDA (BA PSYCHOLOGY)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LERIDA
Last Name:OSPINA
Suffix:
Gender:F
Credentials:BA PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 ARGONNE AVE S
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33974-9707
Mailing Address - Country:US
Mailing Address - Phone:239-425-5842
Mailing Address - Fax:
Practice Address - Street 1:2180 MARAVILLA LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-7221
Practice Address - Country:US
Practice Address - Phone:239-332-8009
Practice Address - Fax:239-332-4977
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator