Olga Pavlovna Ivanova, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS64450 Issued in FL

Practice address

13960 Landstar Blvd
Orlando, FL 32824-5524

Phone

(407) 438-6850

NPI assigned

Aug 1, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Holiday CVS L.L.C.

  dba Cvs Pharmacy #17915

  • Pharmacy
  • Wesley Chapel, FL
  • NPI 1770467466
  NPD (past)
• Holiday CVS LLC

  dba CVS Pharmacy 05853

  • Pharmacy
  • Orlando, FL
  • NPI 1922102904
  NPD (past)

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1447987433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 CARIBOU DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347594214",
            "telephone_number": "347-592-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13960 LANDSTAR BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328245524",
            "telephone_number": "407-438-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANOVA",
        "first_name": "OLGA",
        "middle_name": "PAVLOVNA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS64450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA STATE PHARMACIST LICENSE",
            "identifier": "PS64450",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grantley Ittera, APRN
• Vidyawati Devi Itwaru-Womack, NBC-HWC
• Cornelia Iucha, PH.D.
• Robert S Iurcovich, MD
• Yaron Ivan, M.D
• Denys Ivasechko, PHARMD
• Sandra Sue Iverson, PA-C
• Lizmarie Ivery
• Carmen Arrufat Ives, APRN
• John Morton Ives Jr., MD

• Pharmacist in Orlando, FL
• Providers in Orlando, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.