Healthcare Provider Details

I. General information

NPI: 1659200020
Provider Name (Legal Business Name): LAURIES OLIVARES CPT, CMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2873 FALLING TREE CIR
ORLANDO FL
32837-7043
US

IV. Provider business mailing address

2873 FALLING TREE CIR
ORLANDO FL
32837-7043
US

V. Phone/Fax

Practice location:
  • Phone: 407-538-7872
  • Fax:
Mailing address:
  • Phone: 407-538-7872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number2024101142548
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: