Provider Demographics
NPI:1740713460
Name:PENISSI, OSWALDO (APRN)
Entity type:Individual
Prefix:
First Name:OSWALDO
Middle Name:
Last Name:PENISSI
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 SAN BENITO DR
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-1838
Mailing Address - Country:US
Mailing Address - Phone:786-498-8001
Mailing Address - Fax:570-206-9334
Practice Address - Street 1:7000 SAN BENITO DR
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-1838
Practice Address - Country:US
Practice Address - Phone:786-498-8001
Practice Address - Fax:570-206-9334
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2025-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11039062363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily