Provider Demographics
NPI:1104536820
Name:ALARCON SEGURA, OSMAR (FNP-BC)
Entity type:Individual
Prefix:
First Name:OSMAR
Middle Name:
Last Name:ALARCON SEGURA
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13231 SW 272ND LN
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8584
Mailing Address - Country:US
Mailing Address - Phone:954-982-4340
Mailing Address - Fax:
Practice Address - Street 1:13231 SW 272ND LN
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8584
Practice Address - Country:US
Practice Address - Phone:954-982-4340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023153363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily