Provider Demographics
NPI:1659318707
Name:OLIVA MEDICAL SUPPLIES & EQUIPMENT, INC.
Entity Type:Organization
Organization Name:OLIVA MEDICAL SUPPLIES & EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:F
Authorized Official - Last Name:ALEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-825-0250
Mailing Address - Street 1:2342 W 80TH ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5576
Mailing Address - Country:US
Mailing Address - Phone:305-825-0250
Mailing Address - Fax:305-825-0350
Practice Address - Street 1:2342 W 80TH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5576
Practice Address - Country:US
Practice Address - Phone:305-825-0250
Practice Address - Fax:305-825-0350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312853332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5666560001Medicare ID - Type Unspecified