MEDICARE: ANDREA OLAVE PA-C

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	390200000X	Student in an Organized Health Care Education/Training Program
2	363AM0700X	Medical Physician Assistant	PA9117500	FL

General Provider Information

NPI Number	:	1982283735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA OLAVE PA-C

Provider Business Mailing Address
First Line	:	1319 BARRINGTON DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5004
Country	:	US
Telephone Number	:	561-452-2535
Fax Number	:

Provider Business Practice Location Address
First Line	:	1319 BARRINGTON DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5004
Country	:	US
Telephone Number	:	561-452-2535
Fax Number	:

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

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	10/23/2023

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