Individual
JOSE EDUARDO OSORIO-LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6150 N US HIGHWAY 41, APOLLO BEACH, FL 33572-1806
(813) 641-0007
(813) 641-0009
Mailing address
2370 CORPORATE CIR, STE 300, HENDERSON, NV 89074-7760
(702) 910-3950
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9101902
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291210400
—
FL
Enumeration date
08/13/2006
Last updated
01/30/2023
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