Healthcare Provider Details

I. General information

NPI: 1720756406
Provider Name (Legal Business Name): OLIVIA PARDI RAHMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2021
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 7TH ST S STE 300
ST PETERSBURG FL
33701-4734
US

IV. Provider business mailing address

PO BOX 748817
ATLANTA GA
30374-8817
US

V. Phone/Fax

Practice location:
  • Phone: 727-954-7121
  • Fax: 888-720-4729
Mailing address:
  • Phone: 727-820-7778
  • Fax: 727-820-7779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11015119
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: