Provider Demographics
NPI:1750634309
Name:OLKUCH, SANIQUE (ARNP)
Entity Type:Individual
Prefix:
First Name:SANIQUE
Middle Name:
Last Name:OLKUCH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SANIQUE
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:3510 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3840
Mailing Address - Country:US
Mailing Address - Phone:305-576-1234
Mailing Address - Fax:305-571-2025
Practice Address - Street 1:3510 BISCAYNE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3840
Practice Address - Country:US
Practice Address - Phone:305-576-1234
Practice Address - Fax:305-571-2025
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9293175363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily