Provider Demographics
NPI:1124825567
Name:OSORIO, NATALIA
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:OSORIO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9013 SHELDON CHASE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-1094
Mailing Address - Country:US
Mailing Address - Phone:561-460-6219
Mailing Address - Fax:
Practice Address - Street 1:4125 GUNN HWY STE B1
Practice Address - Street 2:
Practice Address - City:CARROLLWOOD
Practice Address - State:FL
Practice Address - Zip Code:33618-8788
Practice Address - Country:US
Practice Address - Phone:561-460-6219
Practice Address - Fax:813-761-0950
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA22077235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist