MEDICARE: OPTIMUM HEALTH CARE SOLUTIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	9108830	FL

General Provider Information

NPI Number	:	1427591841
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMUM HEALTH CARE SOLUTIONS

Provider Business Mailing Address
First Line	:	PO BOX 3195
Second Line	:
City	:	LANTANA
State	:	FL
Zip	:	33465-3195
Country	:	US
Telephone Number	:	215-527-5094
Fax Number	:

Provider Business Practice Location Address
First Line	:	3589 S OCEAN BLVD
Second Line	:	#107
City	:	SOUTH PALM BEACH
State	:	FL
Zip	:	33480-5753
Country	:	US
Telephone Number	:	215-527-5094
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JANE COHN-MANNINO
Credential	:	PA-C
Telephone Number	:	215-527-5094

Provider Enumeration Date	:	12/02/2016
Last Update Date	:	12/02/2016

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