Provider Demographics
NPI:1356002489
Name:OLSON, PAUL (PA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:OLSON
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1289
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33601-1289
Mailing Address - Country:US
Mailing Address - Phone:813-660-6300
Mailing Address - Fax:
Practice Address - Street 1:2333 W HILLSBOROUGH AVE STE 160
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1061
Practice Address - Country:US
Practice Address - Phone:813-660-6300
Practice Address - Fax:813-660-6620
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2023-10-02
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant