Individual provider Active NPI

Ivan Oliva

  • Psychiatric/Mental Health Nurse Practitioner
  • Coral Springs, FL
National Provider Identifier
1295086106
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11008837 Issued in FL
Practice address
7501 Wiles Rd Ste 202
Coral Springs, FL 33067-2079
Phone
(954) 346-8300
NPI assigned
Oct 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Family Nurse Practitioner 363LF0000X 11008837 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11008837 FL Primary

Addresses

Primary practice location

7501 Wiles Rd Ste 202
Coral Springs, FL 33067-2079

Mailing address

9894 NW 82ND Ave Apt 303
Hialeah Gardens, FL 33016-2531
Phone (561) 319-1847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230623001149 FL Practitioner - Nurse Practitioner 6204294200 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11008837FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dade Family Counseling Community Mental Health Center, Inc CurrentSince Jun 6, 2023 Accepting new patients
Harmony & Hope Mental Center LLC Psychiatric/Mental Health CurrentSince Nov 3, 2025 Accepting new patients
Rega Mental Health Center, LLC PastSince Apr 28, 2024 Accepting new patients
Broward Institute of Neuro Science L L C PastSince Mar 30, 2025 Accepting new patients
Rega Mental Health Center, LLC PastSince Mar 30, 2025 Accepting new patients

Locations

9350 Sunset Dr
Ste 151
Miami, FL 33173
Phone (786) 548-1022

1951 NW 17th Ave
Miami, FL 33125
Phone (305) 265-9220

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1295086106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9894 NW 82ND AVE APT 303",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "330162531",
            "telephone_number": "561-319-1847",
            "fax_number": "786-610-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 WILES RD STE 202",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330672079",
            "telephone_number": "954-346-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVA",
        "first_name": "IVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-02",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11008837",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11008837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.