MEDICARE: MARIA O HERNANDEZ 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	363AM0700X	Medical Physician Assistant	TPPA1099	FL

General Provider Information

NPI Number	:	1881553386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA O HERNANDEZ OLIVER

Provider Business Mailing Address
First Line	:	16214 ARMISTEAD LN
Second Line	:
City	:	ODESSA
State	:	FL
Zip	:	33556-3306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4311 W WATERS AVE STE 304B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-1901
Country	:	US
Telephone Number	:	813-400-2201
Fax Number	:	813-212-5230

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

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “ MARIA O HERNANDEZ OLIVER ” Practice Location

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