MEDICARE: ADRIANA OLIVA ND

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	133V00000X	Registered Dietitian	164.009670	IL
2	133V00000X	Registered Dietitian	ND10426	FL

General Provider Information

NPI Number	:	1437817756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANA OLIVA ND

Provider Business Mailing Address
First Line	:	300 SE 2ND ST STE 600
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-1950
Country	:	US
Telephone Number	:	954-825-8683
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 CHATHAM RD STE 4174
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62704-4188
Country	:	US
Telephone Number	:	954-825-8683
Fax Number	:

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

Provider Enumeration Date	:	12/03/2021
Last Update Date	:	12/09/2025

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