MEDICARE: DOROTHY W OLIVER RN,ARNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN1456452	FL

General Provider Information

NPI Number	:	1457433070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY W OLIVER RN,ARNP

Provider Business Mailing Address
First Line	:	1180 SPRING CENTRE SOUTH BLVD
Second Line	:	SUITE 360
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-1974
Country	:	US
Telephone Number	:	407-862-1108
Fax Number	:

Provider Business Practice Location Address
First Line	:	1180 SPRING CENTRE SOUTH BLVD
Second Line	:	SUITE 360
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-1974
Country	:	US
Telephone Number	:	407-862-1108
Fax Number	:

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	07/08/2007

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