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NPI Code Detail

MEDICARE: DR. EDWIN JOSEPH OLSEN M.D.

MEDICARE: DR. EDWIN JOSEPH OLSEN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianME 54095FL

General Provider Information

NPI Number : 1134238389
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWIN JOSEPH OLSEN M.D.
Provider Business Mailing Address
First Line : 3962 PARK AVE
Second Line :
City : MIAMI
State : FL
Zip : 33133-6436
Country : US
Telephone Number : 305-665-7869
Fax Number : 305-665-0089
Provider Business Practice Location Address
First Line : 1201 NW 16TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33125-1624
Country : US
Telephone Number : 305-575-3214
Fax Number : 305-575-3413
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 07/08/2007

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Directions to “ DR. EDWIN JOSEPH OLSEN M.D.” Practice Location

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