MEDICARE: ALEXANDRA SAXON OLIVA

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	363LF0000X	Family Nurse Practitioner	11036197	FL

General Provider Information

NPI Number	:	1588487102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA SAXON OLIVA

Provider Business Mailing Address
First Line	:	501 LAKE MARIAM LN
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-4500
Country	:	US
Telephone Number	:	863-258-4478
Fax Number	:

Provider Business Practice Location Address
First Line	:	6919 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-3972
Country	:	US
Telephone Number	:	813-680-1405
Fax Number	:

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

Provider Enumeration Date	:	11/02/2024
Last Update Date	:	04/24/2026

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