Individual provider Active NPI

Jennifer R Osorio, CCC-SLP

  • Speech-Language Pathologist
  • Miami, FL
National Provider Identifier
1093024713
Registry record updated Jul 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA11047 Issued in FL
Practice address
12494 SW 127TH Ave
Miami, FL 33186-6597
Phone
(305) 733-3405
NPI assigned
Sep 29, 2010
Last updated
Jul 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA11047 FL Primary

Addresses

Primary practice location

12494 SW 127TH Ave
Miami, FL 33186-6597

Mailing address

11741 SW 110TH Ter
Miami, FL 33186-3927
Phone (305) 733-3405

Other identifiers 1

IdentifierTypeStateIssuer
002675000MedicaidFL

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

State licenses

LicenseStateTypeSpecialty
SA11047FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Exceptional Speech Therapy Current Accepting new patients
Exceptional Speech Therapy Speech-Language Pathologist Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499040000000",
    "number": "1093024713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11741 SW 110TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331863927",
            "telephone_number": "305-733-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12494 SW 127TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331866597",
            "telephone_number": "305-733-3405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSORIO",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2017-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA11047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002675000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.