MEDICARE: OPTIMAL HEALTH PARTNERS,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	207R00000X	Internal Medicine Physician	OS8515	FL

General Provider Information

NPI Number	:	1649304536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMAL HEALTH PARTNERS,LLC

Provider Business Mailing Address
First Line	:	2708 E OAKLAND PARK BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1605
Country	:	US
Telephone Number	:	954-318-0873
Fax Number	:

Provider Business Practice Location Address
First Line	:	2708 E OAKLAND PARK BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1605
Country	:	US
Telephone Number	:	954-318-0873
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES CENNAMO
Credential	:	DO
Telephone Number	:	954-318-0873

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	08/22/2020

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