Provider Demographics
NPI:1194232165
Name:OLIVERIA, FLORENCE MASINNAY BONDAD
Entity type:Individual
Prefix:
First Name:FLORENCE MASINNAY
Middle Name:BONDAD
Last Name:OLIVERIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17912 SHOTLEY BRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1650
Mailing Address - Country:US
Mailing Address - Phone:224-717-1583
Mailing Address - Fax:
Practice Address - Street 1:18131 SLADE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860-1346
Practice Address - Country:US
Practice Address - Phone:301-260-2320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23504225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist