Provider Demographics
NPI:1831388891
Name:NELSON OLAGUIBEL DO PA
Entity type:Organization
Organization Name:NELSON OLAGUIBEL DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:OLAGUIBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-967-3606
Mailing Address - Street 1:1825 FOREST HILL BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-8902
Mailing Address - Country:US
Mailing Address - Phone:561-967-3606
Mailing Address - Fax:561-967-1611
Practice Address - Street 1:1825 FOREST HILL BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-8902
Practice Address - Country:US
Practice Address - Phone:561-967-3606
Practice Address - Fax:561-967-1611
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NELSON OLAGUIBEL, DO, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-16
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005744207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty