Individual
MISS MARTHA ANN OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
701 MEDICAL PLAZA DR, LEESBURG, FL 34748-7313
(352) 326-8115
(352) 326-5282
Mailing address
10 CLARK ST, ENTERPRISE, FL 32725-8106
(386) 507-5269
(855) 879-6592
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9103766
FL
363AS0400X
Surgical Physician Assistant
PAT9103766
FL
Other
Enumeration date
10/06/2006
Last updated
04/13/2020
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