Provider Demographics
NPI:1528825643
Name:NEGRIN MASDIAZ, OSMANI SR
Entity type:Individual
Prefix:MR
First Name:OSMANI
Middle Name:
Last Name:NEGRIN MASDIAZ
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 NW 107TH AVE UNIT R315
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2982
Mailing Address - Country:US
Mailing Address - Phone:786-546-7705
Mailing Address - Fax:
Practice Address - Street 1:1750 NW 107TH AVE UNIT R315
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:FL
Practice Address - Zip Code:33172-2982
Practice Address - Country:US
Practice Address - Phone:786-546-7705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician