1568451847 NPI number — LEONOR M OSORIO D.O.

Table of content: LEONOR M OSORIO D.O. (NPI 1568451847)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568451847 NPI number — LEONOR M OSORIO D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OSORIO
Provider First Name:
LEONOR
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568451847
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7580 NORTHCLIFF AVENUE
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44144-3272
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-472-2741
Provider Business Mailing Address Fax Number:
216-472-2739

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3600 FRANKLIN BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44113-2831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-363-7733
Provider Business Practice Location Address Fax Number:
216-631-7055
Provider Enumeration Date:
10/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  34007712 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 34-007712 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00472854 . This is a "RAILROAD CARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 352524 . This is a "WELLCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2298777 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00705970 . This is a "RRCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com