NPIMap

Organization Active NPI

Olive Health LLC

  • Primary Care Nurse Practitioner
  • Plant City, FL
National Provider Identifier
1124612817
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
OLIVE HEALTH LLC
Practice address
4912 W Trapnell Rd
Plant City, FL 33566-0128
Phone
(813) 417-4767
NPI assigned
Feb 24, 2021
Last updated
Aug 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Yvette Guzman, APRNNPI 1750794376
Title
Owner
Phone
(813) 389-9474

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

4912 W Trapnell Rd
Plant City, FL 33566-0128

Mailing address

4912 W Trapnell Rd
Plant City, FL 33566-0128
Phone (813) 417-4767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210409002152 FL Part B Supplier - Clinic/Group Practice 1153739214 Receives reassigned benefits from 10 practitioners
Practice locations: Plant City, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1124612817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 W TRAPNELL RD",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335660128",
            "telephone_number": "813-417-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4912 W TRAPNELL RD",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335660128",
            "telephone_number": "813-417-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-24",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "GUZMAN",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-389-9474",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.