William A Olivos Od Pa

LBN: William A Olivos Od Pa
William A Olivos Od Pa is an health care organization with primary practice located at 2710 Sw Port St Lucie Blvd , Port Saint Lucie FL 34953-2849. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. William A Olivos Od Pa can be contacted via phone (772) 460-8487, or through Olivos, William A via phone (772) 460-8487.

Contact Information

Primary practice address
2710 Sw Port St Lucie Blvd Port Saint Lucie FL 34953-2849
Phone: (772) 460-8487
Fax: (772) 460-0225
Website:
Map and Directions
Authorized official contact:
Name: Olivos, William A Doctor of Optometry (OD)
Phone: (772) 460-8487

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X

Profile Details

NPI number 1962075358
LBN Legal business name William A Olivos Od Pa
DBA Doing business as
Authorized official Olivos, William A Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 22nd, 2021
Last updated Jul 23rd, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962075358 NPPES
Florida MEDICAID 002946001

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