MEDICARE: ISABEL OLIVAS

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	PS52273	FL

General Provider Information

NPI Number	:	1275942443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISABEL OLIVAS

Provider Business Mailing Address
First Line	:	9633 SW 163RD CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-5833
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9633 SW 163RD CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-5833
Country	:	US
Telephone Number	:	786-205-0231
Fax Number	:

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

Provider Enumeration Date	:	08/12/2014
Last Update Date	:	08/12/2014

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Directions to “ ISABEL OLIVAS ” Practice Location

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