Active NPI
Raul Martinez Osorio Sr., PA
- Physician Assistant
- Hollywood, FL
National Provider Identifier
1003412818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2568-P.A.
- Practice address
- 5512 Mayo St
Hollywood, FL 33021-8022 - Phone
- (305) 588-0720
- NPI assigned
- Dec 7, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 20-463 | WI | |
| Surgical Physician Assistant | 363AS0400X | 2568-P.A. | PR | |
| Physician Assistant | 363A00000X | 2568-P.A. | PR | Primary |
Addresses
Primary practice location
5512 Mayo St
Hollywood, FL 33021-8022
Mailing address
5512 Mayo St
Hollywood, FL 33021-8022
Phone (305) 588-0720
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20-463 | WI | MD | Surgical Assistant |
| 2568-P.A. | PR | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750982400000",
"number": "1003412818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5512 MAYO ST",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330218022",
"telephone_number": "305-588-0720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5512 MAYO ST",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330218022",
"telephone_number": "305-588-0720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSORIO",
"first_name": "RAUL",
"middle_name": "MARTINEZ",
"name_suffix": "Sr.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-07",
"last_updated": "2025-06-27",
"certification_date": "2025-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "WI",
"license": "20-463",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "PR",
"license": "2568-P.A.",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "2568-P.A.",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.