Healthcare Provider Details

I. General information

NPI: 1841067048
Provider Name (Legal Business Name): NATALIA OLMO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2023
Last Update Date: 05/18/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13200 MCCORMICK DR # 1
TAMPA FL
33626-3010
US

IV. Provider business mailing address

218 REMINGTON PL
HAINES CITY FL
33844-8182
US

V. Phone/Fax

Practice location:
  • Phone: 813-814-5971
  • Fax:
Mailing address:
  • Phone: 407-219-2692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT23315254
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: