MEDICARE: ALEJANDRO OLIVEROS NURSE PRACTITIONER

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	363LF0000X	Family Nurse Practitioner	11001940	FL

General Provider Information

NPI Number	:	1457986317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRO OLIVEROS NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	8333 NW 53RD ST FL 6
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33166-4783
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10130 SW 40TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3948
Country	:	US
Telephone Number	:	305-685-5688
Fax Number	:	786-953-1893

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

Provider Enumeration Date	:	03/10/2020
Last Update Date	:	06/01/2026

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Directions to “ ALEJANDRO OLIVEROS NURSE PRACTITIONER” Practice Location

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