Provider Demographics
NPI:1134092422
Name:OLAZABAL MEDICAL CENTER LLC
Entity type:Organization
Organization Name:OLAZABAL MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANNIELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAZABAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-972-8100
Mailing Address - Street 1:2603 NW 10TH AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-4082
Mailing Address - Country:US
Mailing Address - Phone:305-972-8100
Mailing Address - Fax:
Practice Address - Street 1:2603 NW 10TH AVE APT 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-4082
Practice Address - Country:US
Practice Address - Phone:305-972-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch