Provider Demographics
NPI:1932720794
Name:MOSQUERA, OLAYA (PHARMD)
Entity Type:Individual
Prefix:
First Name:OLAYA
Middle Name:
Last Name:MOSQUERA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 N 29TH AVE APT 308
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-1723
Mailing Address - Country:US
Mailing Address - Phone:754-226-3524
Mailing Address - Fax:
Practice Address - Street 1:2140 N 29TH AVE APT 308
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-1723
Practice Address - Country:US
Practice Address - Phone:754-226-3524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS53053183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist