Healthcare Provider Details
I. General information
NPI: 1386454551
Provider Name (Legal Business Name): OPTIMAL HEALTHCARE PROVIDERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/10/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1942 BROADWAY STE 314C
BOULDER CO
80302-5233
US
IV. Provider business mailing address
8279 DOVE RIDGE WAY
PARKER CO
80134-8888
US
V. Phone/Fax
- Phone: 720-303-4976
- Fax: 303-535-4570
- Phone: 561-248-9407
- Fax: 303-535-4570
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081P2900X |
| Taxonomy | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
YASSER
ANTONIO
ESPINAL
Title or Position: PHYSICIAN/MD
Credential: MD
Phone: 561-248-9407