=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881553386
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIA O HERNANDEZ OLIVER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2026
-----------------------------------------------------
Last Update Date | 01/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4311 W WATERS AVE STE 304B
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33614-1901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-400-2201
-----------------------------------------------------
Fax | 813-212-5230
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16214 ARMISTEAD LN
-----------------------------------------------------
City | ODESSA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33556-3306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number | TPPA1099
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------