MEDICARE: DR. ELVIN OLIVERO MD

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	208D00000X	General Practice Physician	14666	PR

General Provider Information

NPI Number	:	1033113659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELVIN OLIVERO MD

Provider Business Mailing Address
First Line	:	1 CALLE FRONTERA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-2229
Country	:	US
Telephone Number	:	787-761-9023
Fax Number	:	787-755-4345

Provider Business Practice Location Address
First Line	:	1 CALLE FRONTERA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-2229
Country	:	US
Telephone Number	:	787-761-9023
Fax Number	:	787-755-4345

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	03/31/2025

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