Provider Demographics
NPI:1295809234
Name:OSMAN, MOHAMED M (PT)
Entity type:Individual
Prefix:MR
First Name:MOHAMED
Middle Name:M
Last Name:OSMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9222 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-5422
Mailing Address - Country:US
Mailing Address - Phone:813-988-9957
Mailing Address - Fax:813-899-2612
Practice Address - Street 1:9222 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-5422
Practice Address - Country:US
Practice Address - Phone:813-988-9957
Practice Address - Fax:813-899-2612
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT11141225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist