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General NPI Number Information
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NPI Number | 1376943506
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Entity Type | Individual
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Provider Name | LAURA S OLIVOS PSY. D.
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Gender | Female
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 975 ARTHUR GODFREY RD STE 303
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3342
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Country | US
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Telephone | 305-792-8168
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Fax | 305-675-0689
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Provider Business Mailing Address
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Address Line | 8129 ABBOTT AVE APT 12
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City | MIAMI BEACH
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State | FL
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Zip | 33141-1658
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Country | US
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Telephone | 772-240-9599
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Fax | 305-675-0689
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY9816
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY9816
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License Number State | FL
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