Healthcare Provider Details

I. General information

NPI: 1316165764
Provider Name (Legal Business Name): JOSEPH OLEAR MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 12TH ST 106
KEY WEST FL
33040-4088
US

IV. Provider business mailing address

1111 12TH ST 106
KEY WEST FL
33040-4088
US

V. Phone/Fax

Practice location:
  • Phone: 305-294-9554
  • Fax:
Mailing address:
  • Phone: 305-294-9554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License NumberME88361
License Number StateFL

VIII. Authorized Official

Name: IVIS FONSECA
Title or Position: BILLING MANAGER
Credential:
Phone: 305-292-3600