Provider Demographics
NPI:1245415892
Name:OLIVERO, KAREN J (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:J
Last Name:OLIVERO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:J
Other - Last Name:CUEVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:813-528-4876
Mailing Address - Fax:
Practice Address - Street 1:2352 BRUCE B DOWNS BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-9203
Practice Address - Country:US
Practice Address - Phone:813-388-6855
Practice Address - Fax:813-355-5894
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104415363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9104415OtherPA9104415
FL293072200Medicaid