Basic Information
| Provider Information | |||||||||
| NPI: | 1811268626 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OLLER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3200 S. UNIVERSITY DRIVE | ||||||||
| Address2: | ASSEMBLY BLDG. 2, ROOM 202 | ||||||||
| City: | FT. LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333282018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542624399 | ||||||||
| FaxNumber: | 9542621172 | ||||||||
| Practice Location | |||||||||
| Address1: | 3200 S. UNIVERSIT DRIVE | ||||||||
| Address2: | SANFORD L. ZIFF BLDG. | ||||||||
| City: | FT. LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333282018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542624100 | ||||||||
| FaxNumber: | 9542622271 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2012 | ||||||||
| LastUpdateDate: | 01/25/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS2443 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.