MEDICARE: MS. ELIZABETH OLIVAS LMT

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	174400000X	Specialist	MA0007392	FL

General Provider Information

NPI Number	:	1104905041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH OLIVAS LMT

Provider Business Mailing Address
First Line	:	1281 NW 48TH PL
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-1020
Country	:	US
Telephone Number	:	954-422-1921
Fax Number	:

Provider Business Practice Location Address
First Line	:	199 W PALMETTO PARK RD
Second Line	:	SUITE 6
City	:	BOCA RATON
State	:	FL
Zip	:	33432-3809
Country	:	US
Telephone Number	:	561-392-3340
Fax Number	:

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/08/2007

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