Provider Demographics
NPI:1003147158
Name:FABIO OLIVEROS & ASSOCIATES PA
Entity Type:Organization
Organization Name:FABIO OLIVEROS & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FABIO
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVEROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-385-2606
Mailing Address - Street 1:130 MEDICAL CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-5463
Mailing Address - Country:US
Mailing Address - Phone:863-385-2606
Mailing Address - Fax:863-382-0184
Practice Address - Street 1:130 MEDICAL CENTER AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5463
Practice Address - Country:US
Practice Address - Phone:863-385-2606
Practice Address - Fax:863-382-0184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93285207RE0101X
FLME94328207RE0101X
FLME0041053207RN0300X
FLME103963207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty