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General NPI Number Information
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NPI Number | 1366091787
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Entity Type | Individual
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Provider Name | ALEJANDRO PEREZ OLIVA APRN
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Gender | Male
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 6307 W 16TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-6219
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Country | US
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Telephone | 305-833-4026
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Fax |
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Provider Business Mailing Address
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Address Line | 6304 NW 105TH PL
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City | DORAL
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State | FL
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Zip | 33178-3269
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Country | US
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Telephone | 305-833-4026
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 18-549
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11022561
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License Number State | FL
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