Provider Demographics
NPI:1811234248
Name:BECERRA, OSMANY
Entity Type:Individual
Prefix:
First Name:OSMANY
Middle Name:
Last Name:BECERRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 BYRON AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-4847
Mailing Address - Country:US
Mailing Address - Phone:786-229-0437
Mailing Address - Fax:
Practice Address - Street 1:8500 BYRON AVE APT 4
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-4847
Practice Address - Country:US
Practice Address - Phone:786-229-0437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program