Provider Demographics
NPI:1477028397
Name:PELLON, OLIMPIA
Entity Type:Individual
Prefix:
First Name:OLIMPIA
Middle Name:
Last Name:PELLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14884 ORANGE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-4506
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14884 ORANGE BLVD
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-4506
Practice Address - Country:US
Practice Address - Phone:561-313-7760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-07
Last Update Date:2018-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered