Provider Demographics
NPI:1225640725
Name:OLAVARRIA RODRIGUEZ, RAFAEL (PHARM D)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:
Last Name:OLAVARRIA RODRIGUEZ
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 POINTE PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-2246
Mailing Address - Country:US
Mailing Address - Phone:941-497-0751
Mailing Address - Fax:
Practice Address - Street 1:4105 POINTE PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-2246
Practice Address - Country:US
Practice Address - Phone:941-497-0751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2022-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist