Healthcare Provider Details

I. General information

NPI: 1578490595
Provider Name (Legal Business Name): SUZANNE OLEA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14505 W GRANITE VALLEY DR
SUN CITY WEST AZ
85375-5795
US

IV. Provider business mailing address

PO BOX 6378
PEORIA AZ
85385-6378
US

V. Phone/Fax

Practice location:
  • Phone: 623-975-8100
  • Fax:
Mailing address:
  • Phone: 602-319-7327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTH-002614
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: