| Olive Health Llc | |
|
4912 W Trapnell Rd Plant City FL 33566-0128 | |
| (813) 417-4767 | |
| Not Available |
| Full Name | Olive Health Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4912 W Trapnell Rd, Plant City, Florida |
| Authorized Official Name and Position | Yvette Guzman (OWNER) |
| Authorized Official Contact | 8133899474 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Olive Health Llc 4912 W Trapnell Rd Plant City FL 33566-0128 Ph: (813) 417-4767 | Olive Health Llc 4912 W Trapnell Rd Plant City FL 33566-0128 Ph: (813) 417-4767 |
| NPI Number | 1124612817 |
|---|---|
| Provider Enumeration Date | 02/24/2021 |
| Last Update Date | 08/30/2023 |
| Certification Date | 08/30/2023 |
| Medicare PECOS PAC ID | 1153739214 |
|---|---|
| Medicare Enrollment ID | O20210409002152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124612817 | NPI | - | NPPES |
| Provider Name | Yvette Guzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750794376 PECOS PAC ID: 9739308222 Enrollment ID: I20140916000336 |
| Provider Name | Melissa Gail Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457710287 PECOS PAC ID: 6002107661 Enrollment ID: I20160629000913 |
| Provider Name | Miranda Dawn Panetta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215332838 PECOS PAC ID: 3274938139 Enrollment ID: I20210816004047 |
| Provider Name | Danielle Polovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447961297 PECOS PAC ID: 7719337872 Enrollment ID: I20240102002203 |
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