# L.A. OLIVERIO,MD ENTERPRISES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194042556
- **Authorized official:** L. A. OLIVERIO M.D. (PRESIDENT/SECRETARY AND DIRECTOR)
- **Authorized official phone:** (352) 489-2401

## Contact information

- **Practice address:** 20661 NED LOVE AVE, DUNNELLON, FL 34431-6767
- **Practice address phone:** (352) 489-2401
- **Practice address fax:** (352) 489-2521
- **Mailing address:** 20661 NED LOVE AVE, DUNNELLON, FL 34431-6767
- **Mailing address phone:** (352) 489-2401
- **Mailing address fax:** (352) 489-2521

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | ME47193 | FL | Yes |

## Other

- **Enumeration date:** 04/26/2010
- **Last updated:** 04/26/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 063686000 | — | FL |