MEDICARE: JOE RAYMOND OLIVAREZ

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
1	174H00000X	Health Educator		CO

General Provider Information

NPI Number	:	1346198488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE RAYMOND OLIVAREZ

Provider Business Mailing Address
First Line	:	3103 HUDSON ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-2942
Country	:	US
Telephone Number	:	719-323-4691
Fax Number	:

Provider Business Practice Location Address
First Line	:	2616 W COLORADO AVE STE 15
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-3073
Country	:	US
Telephone Number	:	719-323-4691
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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