Provider Demographics
NPI:1720388358
Name:OSORIO, JAVIER ALONSO (ATC)
Entity Type:Individual
Prefix:MR
First Name:JAVIER
Middle Name:ALONSO
Last Name:OSORIO
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 CALLE MINERVA
Mailing Address - Street 2:URB DOS PINOS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923-2312
Mailing Address - Country:US
Mailing Address - Phone:787-528-1693
Mailing Address - Fax:
Practice Address - Street 1:408 CALLE MINERVA
Practice Address - Street 2:URB DOS PINOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-2312
Practice Address - Country:US
Practice Address - Phone:787-528-1693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0048842255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer