Individual
DR. MARIO OLAVARRIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-1252
Mailing address
7910 SW 97TH PL, MIAMI, FL 33173-3164
(305) 724-5570
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PY6113
FL
103TH0004X
Health Psychologist
PY6113
FL
103TR0400X
Rehabilitation Psychologist
Primary
PY6113
FL
Other
Enumeration date
04/20/2007
Last updated
08/16/2016
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