Individual
IVAN GUILLERMO OLARTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18344 MURDOCK CIR, PORT CHARLOTTE, FL 33948-1008
(941) 625-6547
(941) 629-6415
Mailing address
18344 MURDOCK CIR, PORT CHARLOTTE, FL 33948-1008
(941) 625-6547
(941) 629-6415
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
ME110134
FL
208600000X
Surgery Physician
4301085888
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14FR5
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/06/2009
Last updated
11/17/2011
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