MEDICARE: OLIVIA BARANSKI 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	390200000X	Student in an Organized Health Care Education/Training Program	ME0160854	IL
2	207Q00000X	Family Medicine Physician	ME0160854	FL

General Provider Information

NPI Number	:	1144844358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA BARANSKI MD

Provider Business Mailing Address
First Line	:	3333 W COMMERCIAL BLVD STE 110
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-3407
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 W COMMERCIAL BLVD STE 110
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3407
Country	:	US
Telephone Number	:	760-201-6711
Fax Number	:

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

Provider Enumeration Date	:	06/03/2020
Last Update Date	:	01/15/2024

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Directions to “ OLIVIA BARANSKI MD” Practice Location

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