Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW381 | FL |
NPI | 1164056362 |
---|---|
Provider Name | Jennifer Lee Osorio |
First Address | Tampa, FL 33603-3926 |
Second Address | Tampa, FL 33602-1522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2020 |
Last Update Date | 26/02/2020 |