Healthcare Provider Details

I. General information

NPI: 1063091460
Provider Name (Legal Business Name): GESIE OLISCAT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 S CONGRESS AVE
ATLANTIS FL
33462-1197
US

IV. Provider business mailing address

7844 RED MAHOGANY RD
BOYNTON BEACH FL
33437-7530
US

V. Phone/Fax

Practice location:
  • Phone: 561-965-7300
  • Fax:
Mailing address:
  • Phone: 561-667-4720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11012376
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: