Provider Demographics
NPI:1144384124
Name:LINARES, OLGA C (PSYD)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:C
Last Name:LINARES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9055 SW 87TH AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2306
Mailing Address - Country:US
Mailing Address - Phone:786-542-8189
Mailing Address - Fax:786-542-8193
Practice Address - Street 1:9055 SW 87TH AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2306
Practice Address - Country:US
Practice Address - Phone:786-542-8189
Practice Address - Fax:786-542-8193
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6511103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDM440AMedicare PIN
FL54879YMedicare PIN