Provider Demographics
NPI:1013549039
Name:OLIVA, BARBARA O (RN 9498405)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:O
Last Name:OLIVA
Suffix:
Gender:F
Credentials:RN 9498405
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 SW 107TH AVE STE 25
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2425
Mailing Address - Country:US
Mailing Address - Phone:786-536-2699
Mailing Address - Fax:
Practice Address - Street 1:2500 SW 107TH AVE STE 25
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2425
Practice Address - Country:US
Practice Address - Phone:786-536-2699
Practice Address - Fax:786-536-7950
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9498405163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse