OLIVIA MICHELLE BULLOCK


Address: 2627 Riverside Ave, Jacksonville, FL 32204-4717
Phone: 9043087372

OLIVIA MICHELLE BULLOCK (NPI# 1114542859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114542859
Entity Type Individual
Full Name OLIVIA MICHELLE BULLOCK
Credential DO
Practice Address 2627 Riverside Ave
Jacksonville
FL 32204-4717
Practice Telephone 9043087372
Mailing Telephone 9043087372
Enumeration Date 2020-06-09
Last Update Date 2020-06-09
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 390200000X Student in an Organized Health Care Education/Training Program UO7189 FL Student, Health Care

Office Location

Street Address 2627 RIVERSIDE AVE
City JACKSONVILLE
State FL
Zip Code 32204-4717

Providers in the same location

NPI Name Taxonomy Address Enumeration
1770575052 Belton Craig Ray Family Medicine 2627 Riverside Ave, Jacksonville, FL 32204-4712 2005-08-22
1215549316 Renee E Alten Student in an Organized Health Care Education/Training Program 2627 Riverside Ave, Jacksonville, FL 32204-4717 2020-08-19
1114538634 Faradia Pierre Student in an Organized Health Care Education/Training Program 2627 Riverside Ave, Jacksonville, FL 32204-4717 2020-08-10
1841817772 Kelsey Rhae Williams Family Medicine 2627 Riverside Ave, Jacksonville, FL 32204-4717 2020-06-26
1477170488 Lisa Michelle Alley Family Medicine 2627 Riverside Ave, Jacksonville, FL 32204-4717 2020-06-26
1104443126 Verniecea J Harris Family Medicine 2627 Riverside Ave, Jacksonville, FL 32204-4717 2020-06-26
1508483421 Lacey J Rokita Family Medicine 2627 Riverside Ave, Jacksonville, FL 32204-4717 2020-06-26
1497372320 Annika Tabassum Family Medicine 2627 Riverside Ave, Jacksonville, FL 32204-4717 2020-06-26
1023635943 Yvonne Nyakio Kamau Family Medicine 2627 Riverside Ave, Jacksonville, FL 32204-4717 2020-06-26
1235754979 Jenna Marie Driscoll Student in an Organized Health Care Education/Training Program 2627 Riverside Ave, Jacksonville, FL 32204-4717 2020-06-09
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437719853 North Florida Surgeons, Pa Orthopaedic Surgery 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 2019-06-18
1770043531 Manuel Viado Rosas Physical Therapist Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 2019-03-20
1255805172 Tracie Nickole Singh Marriage & Family Therapist 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 2019-01-14
1427548544 Bold City Therapy and Wellness LLC Clinic/Center 2054 Park Street, Jacksonville, FL 32204 2018-05-14
1356883078 Lcn Enterprise, LLC Case Manager/Care Coordinator 1225 W Beaver St Ste 106, Jacksonville, FL 32204 2016-11-11
1073065082 Prosser and Prosser LLC Non-emergency Medical Transport (VAN) 2120 Ernest St, Jacksonville, FL 32204 2016-10-26
1336529817 Nader Daoud Internal Medicine 1 Shircliffway, Jacksonville, FL 32204 2015-06-01
1194119214 Benjamin James Dionne Internal Medicine 2 Shircliff Way Ste 400, Jacksonville, FL 32204 2015-03-26
1598187932 Jamara Stephens Counselor 1225 W Beaver St Ste 205, Jacksonville, FL 32204 2014-01-18
1154743961 Kathleen Jasper Nurse Anesthetist, Certified Registered 2165 Herschel Street, Jacksonville, FL 32204 2014-01-14
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Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1548860711 Lee Thomas Hagenbaumer Student in an Organized Health Care Education/Training Program 10100 Baymeadows Rd Apt 802, Jacksonville, FL 32256-7196 2020-10-27
1508463456 Juana Maria Hodac Student in an Organized Health Care Education/Training Program 8680 Baymeadows Rd E Apt 1018, Jacksonville, FL 32256-3994 2020-10-05
1366053043 Amanda Brunner Student in an Organized Health Care Education/Training Program 404 Henry Rd Sw, Jacksonville, AL 36265-3338 2020-08-14
1528679206 Deandrea Joice Stowe Student in an Organized Health Care Education/Training Program 519 Ladiga St Se, Jacksonville, AL 36265-2691 2020-08-14
1558970558 Imran Ahmed Mridha Student in an Organized Health Care Education/Training Program 7932 Southside Blvd Apt 2409, Jacksonville, FL 32256-7958 2020-07-24
1750908588 Irissel Rodriguez Student in an Organized Health Care Education/Training Program 2800 University Blvd S Apt 282, Jacksonville, FL 32216-2587 2020-06-27
1629692413 Diana Piotrowski Student in an Organized Health Care Education/Training Program 100 Magnolia St Apt 6105, Jacksonville, FL 32204-2256 2020-06-08
1922622778 Ryan D'armond Navarre Student in an Organized Health Care Education/Training Program 100 Magnolia St Apt 6213, Jacksonville, FL 32204-2257 2020-06-07
1063036937 Karen Rebecca Clement Student in an Organized Health Care Education/Training Program 4929 Skyway Dr Apt 5212, Jacksonville, FL 32246-0047 2020-06-05
1134743107 Christine Lalime Student in an Organized Health Care Education/Training Program 220 Riverside Ave Unit 203, Jacksonville, FL 32202-4947 2020-06-04
Find all providers in JACKSONVILLE

Competitor

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City JACKSONVILLE
Zip Code 32204

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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