Provider Demographics
NPI:1811965643
Name:OLAZABAL, MARIA DOLORES (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DOLORES
Last Name:OLAZABAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:URB SANTA MARIA
Mailing Address - Street 2:1817 CALLE CAMELIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-365-5110
Mailing Address - Fax:
Practice Address - Street 1:PLAZA SUCHVILLE SUITE 202
Practice Address - Street 2:CARR #2
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-277-0802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR137032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20849Medicare ID - Type Unspecified