Provider Demographics
NPI:1831849231
Name:MATTNER, OLIVIA (DO)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:MATTNER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2304
Mailing Address - Country:US
Mailing Address - Phone:561-955-3945
Mailing Address - Fax:866-622-2185
Practice Address - Street 1:800 MEADOWS RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2304
Practice Address - Country:US
Practice Address - Phone:561-955-3945
Practice Address - Fax:866-622-2185
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program