MEDICARE: OLIVIA LALLOUZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SA23760	FL

General Provider Information

NPI Number	:	1023844495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA LALLOUZ

Provider Business Mailing Address
First Line	:	3335 N UNIVERSITY DR STE 5
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2230
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3335 N UNIVERSITY DR STE 5
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2230
Country	:	US
Telephone Number	:	954-442-9422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2024
Last Update Date	:	02/16/2026

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Directions to “ OLIVIA LALLOUZ ” Practice Location

Language	Start Address	Practice Location

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