Provider Demographics
NPI:1972692853
Name:OLIVER, JAVIER E
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:E
Last Name:OLIVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 CALLE PRINCESA CRISTINA
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5335
Mailing Address - Country:US
Mailing Address - Phone:787-998-6063
Mailing Address - Fax:
Practice Address - Street 1:119 CALLE PRINCESA CRISTINA
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5335
Practice Address - Country:US
Practice Address - Phone:787-998-6063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL859262085R0202X
PR146182085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology