Provider Demographics
NPI:1477866465
Name:OLIVA, MELISA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MELISA
Middle Name:
Last Name:OLIVA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1695 NW 9TH AVE
Mailing Address - Street 2:SUITE 2416
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1409
Mailing Address - Country:US
Mailing Address - Phone:305-355-7285
Mailing Address - Fax:305-355-8095
Practice Address - Street 1:1695 NW 9TH AVE
Practice Address - Street 2:SUITE 2416
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1409
Practice Address - Country:US
Practice Address - Phone:305-355-7285
Practice Address - Fax:305-355-8095
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9199103TC0700X
FLPY87472084P0804X
FLPY 8747103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry