=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740522663
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELIZABETH VILCHES-OLIVERA MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2013
-----------------------------------------------------
Last Update Date | 09/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9195 SW 72ND ST STE 120B
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33173-3488
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-901-5522
-----------------------------------------------------
Fax | 305-901-1513
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9195 SW 72ND ST STE 120B
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33173-3488
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-901-5522
-----------------------------------------------------
Fax | 305-901-1513
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | C12-0000049
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | ME128057
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------