Provider Demographics
NPI:1043528474
Name:BLESILDA H OLFATO, P A
Entity type:Organization
Organization Name:BLESILDA H OLFATO, P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:BLESILDA
Authorized Official - Middle Name:H
Authorized Official - Last Name:OLFATO
Authorized Official - Suffix:
Authorized Official - Credentials:P A
Authorized Official - Phone:941-927-8213
Mailing Address - Street 1:4544 SHADOW LEAF DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233
Mailing Address - Country:US
Mailing Address - Phone:813-754-7756
Mailing Address - Fax:813-754-7565
Practice Address - Street 1:4544 SHADOWLEAF DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2278
Practice Address - Country:US
Practice Address - Phone:813-754-7756
Practice Address - Fax:813-754-7565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250496100Medicaid
FL110174189OtherMEDICARE RAILROAD
FL31256AMedicare PIN