Healthcare Provider Details

I. General information

NPI: 1952216673
Provider Name (Legal Business Name): LAURA PATRICIA OLAVE SR.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 S CONGRESS AVE STE C
DELRAY BEACH FL
33445-7312
US

IV. Provider business mailing address

1100 SW 4TH AVE APT 16A
DELRAY BEACH FL
33444-2280
US

V. Phone/Fax

Practice location:
  • Phone: 395-780-2322
  • Fax:
Mailing address:
  • Phone: 305-780-2322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA96854
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: