Provider Demographics
NPI:1770082406
Name:OSLEY, FAY
Entity type:Individual
Prefix:MRS
First Name:FAY
Middle Name:
Last Name:OSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SW 2ND CT
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-7134
Mailing Address - Country:US
Mailing Address - Phone:954-357-4822
Mailing Address - Fax:
Practice Address - Street 1:1000 SW 2ND CT
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-7134
Practice Address - Country:US
Practice Address - Phone:954-357-4822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator