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Individual

BEN OLWE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
8515 N MITCHELL AVE, TAMPA, FL 33604-1658
(813) 307-8015
(813) 276-2999
Mailing address
1105 E KENNEDY BLVD, TAMPA, FL 33602-3511
(813) 307-8015
(813) 276-2999

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 9100268
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9100268
MEDCIAL LICENSE
FL
Enumeration date
09/08/2009
Last updated
03/05/2015
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