Provider Demographics
NPI:1457384562
Name:CADORNA, OSIAS REYES JR (RPT)
Entity Type:Individual
Prefix:MR
First Name:OSIAS
Middle Name:REYES
Last Name:CADORNA
Suffix:JR
Gender:M
Credentials:RPT
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Mailing Address - Street 1:8466 LOCKWOOD RIDGE RD
Mailing Address - Street 2:#300
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2951
Mailing Address - Country:US
Mailing Address - Phone:941-359-2977
Mailing Address - Fax:941-359-2966
Practice Address - Street 1:255 COURTYARD BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5794
Practice Address - Country:US
Practice Address - Phone:813-633-2887
Practice Address - Fax:813-864-8671
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPT9699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY6797XMedicare ID - Type UnspecifiedMCB