Healthcare Provider Details

I. General information

NPI: 1912109232
Provider Name (Legal Business Name): FLORENCE OLIVAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 W OCEAN VIEW AVE
NORFOLK VA
23503-1502
US

IV. Provider business mailing address

2434 JASPER CT
NORFOLK VA
23518-4535
US

V. Phone/Fax

Practice location:
  • Phone: 757-583-0113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202011547
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: