Organization
JAY E. OLSSON, D.O., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY EDWARD OLSSON D.O. (MEDICAL DIRECTOR)
(321) 242-9031
Entity
Organization
Contact information
Practice address
401 N WICKHAM RD, SUITE S, MELBOURNE, FL 32935-8659
(321) 242-9031
(321) 242-9035
Mailing address
401 N WICKHAM RD, SUITE S, MELBOURNE, FL 32935-8659
(321) 242-9031
(321) 242-9035
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
OS0004087
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K5335
MEDICARE ID
FL
Enumeration date
07/23/2006
Last updated
04/09/2015
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