Provider Demographics
NPI:1356791305
Name:MONTESERIN, OSIEL (APRN FNP MSN)
Entity type:Individual
Prefix:MR
First Name:OSIEL
Middle Name:
Last Name:MONTESERIN
Suffix:
Gender:M
Credentials:APRN FNP MSN
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Other - Middle Name:
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Mailing Address - Street 1:1621 SW 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7344
Mailing Address - Country:US
Mailing Address - Phone:786-422-6525
Mailing Address - Fax:786-621-7815
Practice Address - Street 1:1490 NW 27TH AVE STE 130
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-2173
Practice Address - Country:US
Practice Address - Phone:305-635-7710
Practice Address - Fax:786-621-7817
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL9363400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019159000Medicaid