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General NPI Number Information
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NPI Number | 1235279662
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Entity Type | Individual
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Provider Name | RAFAEL JESUS OLIVA PT
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Gender | Male
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 1500 S DOUGLAS RD STE 210
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City | CORAL GABLES
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State | FL
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Zip | 33134-4108
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Country | US
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Telephone | 305-448-0146
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Fax | 305-448-0147
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Provider Business Mailing Address
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Address Line | 9888 SW 7TH TER
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City | MIAMI
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State | FL
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Zip | 33174-1985
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Country | US
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Telephone | 786-797-5707
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PT16788
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 16788
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 16788
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT16788
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License Number State | FL
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