Provider Demographics
NPI:1124725957
Name:SLIWA, OLIVIA ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ROSE
Last Name:SLIWA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1020 LAKE SUMTER LNDG
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-2699
Mailing Address - Country:US
Mailing Address - Phone:352-674-8905
Mailing Address - Fax:352-674-8901
Practice Address - Street 1:2910 BROWNWOOD BLVD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163-2032
Practice Address - Country:US
Practice Address - Phone:844-884-9355
Practice Address - Fax:352-674-8990
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9117050363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant