Healthcare Provider Details

I. General information

NPI: 1609576958
Provider Name (Legal Business Name): OLYMPUS RESEARCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 03/05/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11285 SW 211TH ST STE 201
MIAMI FL
33189-2213
US

IV. Provider business mailing address

11285 SW 211TH ST STE 207
CUTLER BAY FL
33189-2213
US

V. Phone/Fax

Practice location:
  • Phone: 786-217-8510
  • Fax:
Mailing address:
  • Phone: 786-217-8510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: CARLOS NUNEZ
Title or Position: CFO
Credential:
Phone: 786-217-8510