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General NPI Number Information
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NPI Number | 1669151726
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Entity Type | Individual
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Provider Name | NICHOLAS OLSEN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2023
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 6545 S KANNER HWY
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City | STUART
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State | FL
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Zip | 34997-6330
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Country | US
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Telephone | 772-233-4099
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Fax |
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Provider Business Mailing Address
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Address Line | 9504 MINORCA WAY APT 305
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-8199
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Country | US
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Telephone | 917-513-6630
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 65597
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License Number State | FL
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