MEDICARE: OLESIA KOROTICH

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	183500000X	Pharmacist	PS68537	FL

General Provider Information

NPI Number	:	1104784420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLESIA KOROTICH

Provider Business Mailing Address
First Line	:	14681 BISCAYNE BLVD UNIT 175
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-1211
Country	:	US
Telephone Number	:	608-658-6873
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 N 35TH AVE STE 105
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-5424
Country	:	US
Telephone Number	:	954-265-1299
Fax Number	:

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

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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Directions to “ OLESIA KOROTICH ” Practice Location

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