Individual
DIETANURUN BOSE OMADEVUAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10920 MOSS PARK RD, ORLANDO, FL 32832-6086
(407) 930-4339
(407) 745-1326
Mailing address
1092 ARLINGTON PLAZA, 1724, OMAHA, NE 68164-5028
(407) 549-8320
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/16/2021
Last updated
05/13/2025
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