MEDICARE: MARIZELI A OLACIO DPM PA

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	213ES0103X	Foot & Ankle Surgery

General Provider Information

NPI Number	:	1548526676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARIZELI A OLACIO DPM PA

Provider Business Mailing Address
First Line	:	9838 NE 2ND AVE
Second Line	:
City	:	MIAMI SHORES
State	:	FL
Zip	:	33138-2313
Country	:	US
Telephone Number	:	305-758-7878
Fax Number	:	305-754-2574

Provider Business Practice Location Address
First Line	:	9838 NE 2ND AVE
Second Line	:
City	:	MIAMI SHORES
State	:	FL
Zip	:	33138-2313
Country	:	US
Telephone Number	:	305-758-7878
Fax Number	:	305-754-2574

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIZELI A OLACIO
Credential	:	DPM
Telephone Number	:	305-321-4574

Provider Enumeration Date	:	04/03/2012
Last Update Date	:	04/03/2012

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