MEDICARE: MRS. SANDRA OLAYA

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	225X00000X	Occupational Therapist	5285	FL

General Provider Information

NPI Number	:	1982820973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANDRA OLAYA

Provider Business Mailing Address
First Line	:	2836 ALOMA LAKE RUN
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-7391
Country	:	US
Telephone Number	:	407-971-4284
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 ALAFAYA WOODS BLVD
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-7095
Country	:	US
Telephone Number	:	407-971-4284
Fax Number	:

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	07/08/2007

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