Individual provider Active NPI

Carlos Shayan Osorio, PT, DPT

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1659188175
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT42127 Issued in FL
Practice address
4411 N Habana Ave
Tampa, FL 33614-7211
Phone
(813) 872-2771
NPI assigned
Dec 17, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT42127 FL Primary

Addresses

Primary practice location

4411 N Habana Ave
Tampa, FL 33614-7211

Mailing address

9013 Sheldon Chase Dr
Tampa, FL 33635-1094
Phone (772) 200-7078

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
PT42127FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1659188175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9013 SHELDON CHASE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336351094",
            "telephone_number": "772-200-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 N HABANA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147211",
            "telephone_number": "813-872-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSORIO",
        "first_name": "CARLOS",
        "middle_name": "SHAYAN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.