MEDICARE: MRS. MANAL OLIVER

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	376G00000X	Nursing Home Administrator

General Provider Information

NPI Number	:	1285305912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MANAL OLIVER

Provider Business Mailing Address
First Line	:	301 W 41ST ST STE 501
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3609
Country	:	US
Telephone Number	:	305-868-7620
Fax Number	:

Provider Business Practice Location Address
First Line	:	1845 GARFIELD ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-3115
Country	:	US
Telephone Number	:	305-868-7620
Fax Number	:

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

Provider Enumeration Date	:	09/22/2021
Last Update Date	:	09/22/2021

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Directions to “ MRS. MANAL OLIVER ” Practice Location

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