Individual provider Active NPI

Osvail L Dias

  • Clinical Social Worker
  • Lauderdale by the Sea, FL
National Provider Identifier
1003067711
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 14273 Issued in FL
Practice address
218 Commercial Blvd
Suite 232
Lauderdale by the Sea, FL 33308-4451
Phone
(617) 910-7034
Fax
(954) 492-0334
NPI assigned
Oct 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW 14273 FL Primary

Addresses

Primary practice location

218 Commercial Blvd
Suite 232
Lauderdale by the Sea, FL 33308-4451

Mailing address

4117 Bougainvilla Dr
Apt. 111
Lauderdale by the Sea, FL 33308-5415
Phone (617) 910-7034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170612002624 FL Practitioner - Clinical Social Worker 2668634585 Practice locations: Lauderdale by the Sea, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 14273FLMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1003067711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 BOUGAINVILLA DR",
            "address_2": "APT. 111",
            "city": "LAUDERDALE BY THE SEA",
            "state": "FL",
            "postal_code": "333085415",
            "telephone_number": "617-910-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 COMMERCIAL BLVD",
            "address_2": "SUITE 232",
            "city": "LAUDERDALE BY THE SEA",
            "state": "FL",
            "postal_code": "333084451",
            "telephone_number": "617-910-7034",
            "fax_number": "954-492-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAS",
        "first_name": "OSVAIL",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-01",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 14273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale by the Sea, FL

Sources for this page

Verify at the official NPI Registry.