Provider Demographics
NPI:1629474143
Name:ALVAREZ DIAZ, OLIDAYSI (APRN)
Entity Type:Individual
Prefix:MISS
First Name:OLIDAYSI
Middle Name:
Last Name:ALVAREZ DIAZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 NW 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-2602
Mailing Address - Country:US
Mailing Address - Phone:305-588-4386
Mailing Address - Fax:
Practice Address - Street 1:4410 W 16TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7100
Practice Address - Country:US
Practice Address - Phone:305-824-8559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9358500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily