Provider Demographics
NPI:1629832019
Name:OLEGARIO, CAROLINE ARANCON
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ARANCON
Last Name:OLEGARIO
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 1:1930 SE HILLMOOR DR APT 138
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7759
Mailing Address - Country:US
Mailing Address - Phone:954-391-3218
Mailing Address - Fax:
Practice Address - Street 1:1930 SE HILLMOOR DR APT 138
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7759
Practice Address - Country:US
Practice Address - Phone:954-391-3218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT32483225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty