Provider Demographics
NPI:1821855537
Name:OLIVEIRA, VIRGINIA M (LPN)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:M
Last Name:OLIVEIRA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 BENNETT RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6008
Mailing Address - Country:US
Mailing Address - Phone:321-947-2170
Mailing Address - Fax:
Practice Address - Street 1:1121 BENNETT RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6008
Practice Address - Country:US
Practice Address - Phone:321-947-2170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9540167163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse