Provider Demographics
NPI:1457827388
Name:ELIAS, OLGA MARGARITA (ARNP)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:MARGARITA
Last Name:ELIAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:MARGARITA
Other - Last Name:ELIAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1506 WHITEHALL DR APT 403
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-6614
Mailing Address - Country:US
Mailing Address - Phone:754-234-2721
Mailing Address - Fax:
Practice Address - Street 1:1506 WHITEHALL DR APT 403
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-6614
Practice Address - Country:US
Practice Address - Phone:754-234-2721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9331489363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner