Provider Demographics
NPI:1225072515
Name:BELDER, OLGA (DO)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:BELDER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 UNIVERSITY PKWY STE 112
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2809
Mailing Address - Country:US
Mailing Address - Phone:941-210-4570
Mailing Address - Fax:941-210-4590
Practice Address - Street 1:2415 UNIVERSITY PKWY STE 112
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2809
Practice Address - Country:US
Practice Address - Phone:941-210-4570
Practice Address - Fax:941-210-4590
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS15026207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100075800Medicaid
NJH66659Medicare UPIN
NJ059822DP4Medicare PIN