Healthcare Provider Details

I. General information

NPI: 1790294163
Provider Name (Legal Business Name): OLGA THOMPSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2017
Last Update Date: 07/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2734 SW 37TH AVE
MIAMI FL
33133
US

IV. Provider business mailing address

620 NW 88TH ST
EL PORTAL FL
33150-2451
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-4263
  • Fax: 305-426-3329
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9338270
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: