Individual
JAIRO MARTIN OLIVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-1715
(352) 392-1161
Mailing address
PO BOX 100383, GAINESVILLE, FL 32610-0383
(352) 392-4541
(352) 294-8519
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME138665
FL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
ME138665
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122467500
—
FL
Enumeration date
04/14/2015
Last updated
07/26/2024
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