Organization
JOAN D OLEARY MD PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN D OLEARY MD (PRESIDENT)
(904) 278-3100
Entity
Organization
Contact information
Practice address
1555 KINGSLEY AVE, SUITE 401, ORANGE PARK, FL 32073-4560
(904) 278-3100
(904) 278-4463
Mailing address
1555 KINGSLEY AVE, SUITE 401, ORANGE PARK, FL 32073-4560
(904) 278-3100
(904) 278-4463
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME64412
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18934B
PTAN
FL
Enumeration date
09/11/2012
Last updated
09/11/2012
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