MEDICARE: OPTIMIND MEDICAL GROUP LLC

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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1578407714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMIND MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	7601 N FEDERAL HWY STE 245A
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33487-1672
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7601 N FEDERAL HWY STE 245A
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33487-1672
Country	:	US
Telephone Number	:	561-704-6781
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RANDY HERFIELD
Credential	:
Telephone Number	:	561-704-6781

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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