Provider Demographics
NPI:1780320655
Name:LE GLOAHEC, OLIVIER (DNP, FNP)
Entity type:Individual
Prefix:DR
First Name:OLIVIER
Middle Name:
Last Name:LE GLOAHEC
Suffix:
Gender:M
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 ALTA MEADOWS LN APT 701
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-1156
Mailing Address - Country:US
Mailing Address - Phone:561-702-8634
Mailing Address - Fax:
Practice Address - Street 1:4800 LINTON BLVD STE F107
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6506
Practice Address - Country:US
Practice Address - Phone:561-498-5660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11019583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily