Healthcare Provider Details

I. General information

NPI: 1134092422
Provider Name (Legal Business Name): OLAZABAL MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 NW 10TH AVE APT 101
MIAMI FL
33127-4082
US

IV. Provider business mailing address

2603 NW 10TH AVE APT 101
MIAMI FL
33127-4082
US

V. Phone/Fax

Practice location:
  • Phone: 305-972-8100
  • Fax:
Mailing address:
  • Phone: 305-972-8100
  • Fax: 305-290-2574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANNIELLY OLAZABAL
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 305-972-8100