Provider Demographics
NPI:1225660103
Name:OLYMPUS HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:OLYMPUS HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SURI
Authorized Official - Middle Name:
Authorized Official - Last Name:AMADOR-CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-442-5503
Mailing Address - Street 1:8300 W FLAGLER ST STE 170
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2098
Mailing Address - Country:US
Mailing Address - Phone:786-633-5171
Mailing Address - Fax:786-558-9279
Practice Address - Street 1:8300 W FLAGLER ST STE 170
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2098
Practice Address - Country:US
Practice Address - Phone:786-633-5171
Practice Address - Fax:786-558-9279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-07
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116165900Medicaid
FL105887400Medicaid
FL107837900Medicaid
FL120214100Medicaid