Provider Demographics
NPI:1134617566
Name:OSORIO, CESAR AUGUSTO (RBT)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:AUGUSTO
Last Name:OSORIO
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 GOLDEN CANE DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2431
Mailing Address - Country:US
Mailing Address - Phone:305-725-7305
Mailing Address - Fax:954-861-2920
Practice Address - Street 1:1145 GOLDEN CANE DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33327-2431
Practice Address - Country:US
Practice Address - Phone:305-725-7305
Practice Address - Fax:954-861-2920
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT18-53374106S00000X
FLRBT-18-53374106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty