Provider Demographics
NPI:1205054251
Name:DE LA OSSA, PATRICIA DOLORES (PT)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:DOLORES
Last Name:DE LA OSSA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 HEMINGWAY DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-5248
Mailing Address - Country:US
Mailing Address - Phone:941-497-5356
Mailing Address - Fax:941-496-4059
Practice Address - Street 1:4126 HEMINGWAY DR
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-5248
Practice Address - Country:US
Practice Address - Phone:941-497-5356
Practice Address - Fax:941-496-4059
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL008999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist