Healthcare Provider Details

I. General information

NPI: 1598629925
Provider Name (Legal Business Name): OLIVE TREE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8175 NW 12TH ST STE 216
DORAL FL
33126-1828
US

IV. Provider business mailing address

8175 NW 12TH ST STE 216
DORAL FL
33126-1828
US

V. Phone/Fax

Practice location:
  • Phone: 305-796-4987
  • Fax: 305-402-0406
Mailing address:
  • Phone: 305-796-4987
  • Fax: 305-402-0406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MADAY BELLO LEMUS
Title or Position: OWNER
Credential: APRN
Phone: 786-531-5623