Basic Information
| Provider Information | |||||||||
| NPI: | 1235587312 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NANO | ||||||||
| FirstName: | OLGER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D, M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 703 N FLAMINGO RD | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330281006 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 374 STOCKHOLM ST | ||||||||
| Address2: | DEPARTMENT OF INTERNAL MEDICINE | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112374006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189637272 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2016 | ||||||||
| LastUpdateDate: | 06/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | TRN32258 | FL | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 71163 | WI | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.